Women who have a history of high blood pressure only during pregnancy are no more likely to receive preventive health care than women without high blood pressure, according to the results of a study published in. JACC: Advance.
Within 5 years of gestational hypertension (HDP), individuals who have given birth are at increased risk of hypertension, metabolic syndrome, and hyperlipidemia, and, throughout life, women with a history of HDP have a higher risk of cardiovascular disease (CVD).
The investigators analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) for this study. Women aged 18 to 45 in the United States (n = 3319) who had at least one child under 5 years of age living in the household between 2021 and 2023 were assessed for health care utilization based on whether they had hypertension (7.6%), pregnancy-only hypertension (9.4%), or no hypertension (83.1%).
After weighting, the mean ages of women with hypertension (n=240,354), pregnancy-only hypertension (n=297,488), or no hypertension (n=2,637,820) were 33.2, 29.5, and 29.5 years, respectively (P =.004); 46.1%, 68.8%, and 55.5% were white (P <.001); and 20.7%, 14.1%, and 11.6% had a CVD-related chronic condition (P =.029), respectively.
These findings highlight the need for clinical and policy changes to ensure that women with a history of HDP have adequate follow-up and continuous surveillance to monitor their cardiovascular health.
In the pooled study population, 79.6% of women had a personal health care provider (HCP), 70.0% had a checkup in the past year, 48.8% had their cholesterol checked in the past year, and 14.0% did not seek medical care due to affordability issues in the past year.
Depending on hypertension status, more women with hypertension had their cholesterol checked in the past year (71.3%); P <.001) compared with women with hypertension only in pregnancy (48.8%) or women without hypertension (47.4%).
In the adjusted model, compared with women without hypertension, women with hypertension were 9.0% more likely to have a personal HCP and 19.8% more likely to have a recent cholesterol check, whereas no differential trends were seen among women with only gestational hypertension.
Based on race and ethnicity, black versus white women with hypertension were more likely to have a personal HCP (estimated percentage increase, 18% vs. 10.2%) and recent cholesterol screening (estimated percentage increase, 30.7% vs. 23.3%), and white women with hypertension were more likely to have a recent screening (estimated percentage increase, 20.2%) than their counterparts without hypertension. No differential trends were seen among Hispanic women or women with only pregnancy hypertension of any race or ethnicity.
This study was limited by non-specific measurement of time elapsed since birth. Some women may be reporting trends in health care utilization prior to pregnancy after recent delivery.
Study investigators concluded, “Among women who had a first-time birth in the past 5 years, women who had high blood pressure during pregnancy and who recovered had health care access and utilization patterns similar to women who were never diagnosed with high blood pressure. These findings highlight the need for clinical and policy changes to ensure that women with a history of high blood pressure, hdp There should be adequate follow-up and continuous monitoring to monitor them cardiovascular health“
