Association between body mass index and chronic hypertension in patients with hypertension disorders of pregnancy one-year postpartum

Ronald Anguzu; Christine M Livergood; Kara K Hoppe; Jacquelyn Kulinski; Garrett D Fitzgerald; Anna Palatnik

doi:10.1016/j.preghy.2023.12.003

Association between body mass index and chronic hypertension in patients with hypertension disorders of pregnancy one-year postpartum

Pregnancy Hypertens. 2024 Mar:35:32-36. doi: 10.1016/j.preghy.2023.12.003. Epub 2023 Dec 21.

Authors

Ronald Anguzu¹, Christine M Livergood², Kara K Hoppe³, Jacquelyn Kulinski⁴, Garrett D Fitzgerald², Anna Palatnik⁵

Affiliations

¹ Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: ranguzu@mcw.edu.
² Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, USA.
³ Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Wisconsin-Madison School of Medicine and Public Health, WI, USA.
⁴ Department of Medicine, Division of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA; Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA.
⁵ Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, USA; Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA.

PMID: 38134483
PMCID: PMC10939881 (available on 2025-03-01)
DOI: 10.1016/j.preghy.2023.12.003

Abstract

Objectives: To determine the association between body mass index (BMI) and chronic hypertension (CHTN) one-year postpartum following pregnancies complicated by hypertensive disorders of pregnancy (HDP).

Study design: A retrospective cohort study of patients with HDP (gestational hypertension or preeclampsia) in a single Midwestern academic center from 2014 to 2018. The primary outcome was CHTN at one-year postpartum, defined as systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 80 mmHg or taking antihypertensive medication at one-year postpartum. The primary exposure variable was BMI at one-year postpartum, categorized as underweight (<18.5 kg/m²), normal (18.5-24.9 kg/m²), overweight (25-<30 kg/m²), and obese (≥30 kg/m²) and as continuous BMI variable. Descriptive statistics and adjusted logistic regression analysis were performed.

Results: Out of 596 patients with HDP included in this analysis, 275 (46.1 %) had CHTN one-year postpartum. Mean one-year postpartum BMI was 27.9 ± 5.2 kg/m². Prevalence of CHTN at one-year postpartum was higher in obese (38.1 %) and overweight (30.0 %) groups compared to the normal weight group (29.9 %), p < 0.001. In multivariate logistic regression, obesity at one-year postpartum, compared to normal, was associated with 73 % higher likelihood of CHTN following HDP (adjusted OR 1.73, 95 % CI 1.06-2.84). With BMI as a continuous variable, each unit increase in BMI one-year postpartum was associated with 6 % higher likelihood of CHTN (adjusted OR 1.06, 95 % CI 1.02-1.15).

Conclusions: Obesity at one-year postpartum following HDP was associated with a higher risk of CHTN compared with normal BMI. Weight is a modifiable risk factor that should be targeted in postpartum interventions to reduce cardiovascular disease following HDP.

Keywords: Body mass index; Chronic hypertension; Hypertension disorders of pregnancy; Obesity; One-year postpartum.

MeSH terms

Body Mass Index
Female
Humans
Hypertension, Pregnancy-Induced*
Obesity / complications
Obesity / epidemiology
Overweight
Postpartum Period
Pre-Eclampsia*
Pregnancy
Retrospective Studies
Risk Factors

Abstract

MeSH terms

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