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Hypertension

Poster Session 2

(447) Factors associated with persistent severe hypertension in patients with preeclampsia

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Hypertensive disorders of pregnancy are a leading cause of maternal morbidity and adverse pregnancy outcomes. We sought to examine factors that were associated with persistent severe hypertension.

Study Design: This was a retrospective study of patients with preeclampsia who delivered at 23 weeks’ gestation or greater from January 1, 2010, to December 31, 2020 at a single academic institution. Analyses were limited to patients with preeclampsia who developed acute severe hypertension (systolic pressure 160 mmHg or diastolic pressure 110 mmHg) and received anti-hypertensive medications during the hospital stay. Our primary outcome was persistent severe hypertension, defined as persistent severe hypertension even after the first dose of anti-hypertensive medication. Variables with p-value < 0.1 were included in multivariable logistic regression to calculate adjusted odds ratios (aORs) and 95% confidence intervals (95%CI).

Results: Of 822 patients with preeclampsia, 376 (45.7%) had persistent severe hypertension after the first dose of anti-hypertensive medication and 446 (54.3%) had resolution of severe hypertension. AORs of variables with P-values less than 0.1 are presented in Table 2. Patients with chronic hypertension compared to those without had increased odds of persistent severe hypertension (aOR 1.43; 95%CI 1.07-1.92). For every 10 mmHg increase in the systolic pressure, there were increased odds of persistent severe hypertension (aOR 1.35; 95%CI 1.20-1.51). BMI 40 or greater compared with BMI< 40 was associated with increased odds of persistent severe hypertension (aOR 1.61; 95%CI 1.19-2.19). Gestational age < 34 weeks compared with gestational age 34 weeks or greater was associated with increased odds of persistent severe hypertension (aOR 1.40; 95%CI 1.04-1.88). Smoking was not associated with increased odds of persistent severe hypertension.  

Conclusion:

We found that chronic hypertension, BMI of at least 40, the degree of severe hypertension, and gestational age < 34 weeks were associated with difficult acute blood pressure control.