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Background: Oral furosemide postpartum improves the time to hypertension resolution in randomized control trials. Further investigation is needed to determine the impact of furosemide in routine clinical practice., Objective: Real world study to assess impact of furosemide on rates of postpartum hypertension and readmissions for patients with hypertensive disorders of pregnancy., Study Design: A prospective cohort study of postpartum patients with hypertensive disorders of pregnancy at a single institution between October 2021 and April 2022. Patients were enrolled in the remote postpartum blood pressure monitoring program (RPM) as standard of care. Use of oral furosemide for 5 days postpartum was implemented per protocol for all patients with gestational hypertension and preeclampsia. Data was obtained until six weeks postpartum. Exclusion criteria included age less than 18 years old, patients with chronic hypertension alone without superimposed preeclampsia, and patients who did not provide consent for data collection. The primary outcome was hospital readmission within six weeks postpartum. The secondary outcome was blood pressure values across those six weeks. Hypertension was defined as any blood pressure value with SBP ≥ 140 mmHg or DBP ≥ 90 mmHg., Results: Overall, 545 patients were enrolled in the RPM program during the study period, 306 of them consented to data collection and 258 patients were ultimately included after meeting all inclusion criteria with no exclusions. Of these, 203 patients received furosemide. Overall, 47.7 % of patients had gestational hypertension, 40.3 % of patients had preeclampsia with or without severe features, and 12.0 % of patients had superimposed preeclampsia with or without severe features. In total, 24.2 % of patients were discharged home on an antihypertensive medication in addition to furosemide. The overall rate of readmission was 13.2 %. There was no difference between patients who received oral furosemide versus those who did not (12.8 % vs 14.6 %, p = 0.74). Rates of hypertension at the one-week postpartum visit between those two groups did not differ significantly (32.8 % [oral furosemide] vs 36.2 % [no furosemide], p = 0.66). Diastolic blood pressures at the six-week follow-up visit were lower in the furosemide group (74 [69,81] vs 82 [76,89]; p = 0.02) among patients registered to care who completed the six-week visit., Conclusion: The addition of furosemide did not result in improved blood pressure control by the first week postpartum or fewer hospital readmissions. However, diastolic blood pressure trended lower at the six-week visit in patients who received furosemide., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: SR reports serving as a consultant for Roche Diagnostics, Thermo Fisher, Beckman Coulter, Siemens and has received research funding from Roche Diagnostics and Siemens for work related to angiogenic biomarkers unrelated to the submitted work. All other authors report no conflict of interests., (Copyright © 2025 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

Objective: To describe postpartum visit attendance and postpartum blood pressure control among patients enrolled in a remote patient monitoring program and compare these outcomes by race., Study Design: A prospective cohort study of postpartum patients with a diagnosis of hypertensive disorders of pregnancy at the University of Chicago between October 2021 and April 2022. All patients received remote patient monitoring as routine care but consented separately for the use of their data. Data were obtained from the electronic medical record for up to six weeks postpartum., Main Outcome Measures: The primary outcome was attendance at the first postpartum blood pressure check visit. Secondary outcomes included postpartum blood pressure control, readmissions, and remote patient monitoring response rates. Outcomes were compared by patient-reported race., Results: 545 patients were enrolled in the remote patient monitoring program, of which 306 consented to data collection. 64.7% of patients identified as Black/African American. Attendance for first postpartum blood pressure check was high (overall 84.0%, Black 81.3% and non-Black 88.9%, p = 0.08). The rate of Stage 2 hypertension at six weeks was higher among Black patients than non-Black patients (22.4% vs 2.2%, p < 0.0001). Engagement with remote patient monitoring decreased over the 6-week period, with more attrition among Black patients., Conclusion: There was a high follow-up rate across all patients regardless of race and a decrease in hypertension over the six-week period. However, rates of hypertension were higher, and engagement with the program lower in Black patients, suggesting further work is needed to address this gap., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: S. Rana reports serving as a consultant to Roche Diagnostics and ThermoFisher Scientific and has received funding from Roche Diagnostics and Siemens for studies related to the use of angiogenic factors in pregnancy which is unrelated to work for this manuscript. All other authors report no conflict of interest]., (Copyright © 2024 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

Objective: The purpose of this study was to examine the long-term effect of a quality improvement initiative at one-year post delivery., Study Design: This was a retrospective study of 1480 patients who delivered between October 2018 and June 2020 at the study institution and were enrolled in the Systematic Treatment and Management of PostPartum Hypertension Program (STAMPP). Patients received standardized cuffs, education, and follow-up. At the six-week postpartum follow-up, patients were again given instructions to establish follow-up., Main Outcome Measures: The primary outcome was a visit with a primary care physician (PCP) or cardiologist between 6 weeks and 1 year postpartum., Results: A total of 939 (63 %) patients had some follow-up within twelve months. Of these, 113 (12 %) and 175 (19 %) had follow-up with cardiology and primary care providers, respectively. Patients with no follow-up were more likely to have public aid (73.9 % vs 60.3 %; p < 0.001). 77 % identified as Black, with only 12 % of this cohort following up with cardiology and 13 % with a PCP., Conclusions: Despite specific counseling about long term follow-up, a minority of patients completed one year follow-up, notably amongst Black patients and those with public insurance. Further work is needed to optimize long-term follow-up after HDP to reduce the prevalence of cardiovascular disease, especially amongst high-risk patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)

Objective: This study examined whether use of bedside medication delivery (Meds to Beds, M2B) or on-campus pharmacy at discharge was associated with improved postpartum blood pressure (BP) control compared to outside pharmacy use in patients with hypertensive disorders of pregnancy (HDP)., Study Design: This was a secondary analysis of 357 patients with HDP enrolled in STAMPP-HTN (Systematic Treatment and Management of Postpartum Hypertension Program) who were discharged from delivery admission with antihypertensives between October 2018 and June 2020. Patients were grouped by discharge medication location: M2B/on-campus pharmacy (on-site) versus outside pharmacy (off-site)., Main Outcome Measures: The primary outcome was BP values at the immediate postpartum visit. Secondary outcomes included six-week visit BP values, attendance at both visits, and readmission within six weeks., Results: Median BP values were no different based on pharmacy location at immediate postpartum visit for both systolic ((135 [IQR 127, 139] on-site vs 137 [127, 145] off-site, p = 0.22) and diastolic (81 [74, 91] vs 83 [76, 92], p = 0.45) values. Similar findings were noted at six weeks. Patients who used an off-site pharmacy had higher attendance rates at the immediate postpartum visit but this difference was attenuated after adjusting for group differences (OR 0.67 [95 % CI 0.37-1.20], p = 0.18). Readmission rates were also not different between groups (12.2 % on-site vs 15.8 % off-site pharmacy, p = 0.43)., Conclusion: In the context of a preexisting multicomponent HDP quality improvement program, on-campus pharmacy and bedside medication delivery use was not associated with additional improvement in postpartum BP control, follow-up rates, or readmission rates., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background: Pregnant patients of racial/ethnic minorities have higher preeclampsia rates. Home blood pressure monitoring (HBPM) has been investigated for disparity reduction. Smaller studies showed patients find HBPM to be a helpful intervention postpartum. Further investigation is needed to define the role of HPBM in an at-risk and diverse population antepartum., Objective: To assess patient perception of HBPM among diverse patients at high risk of disease development., Study Design: Prospective study conducted from April 2020-September 2021. HBPM kits were advertised and interested parties across the United States responded. Cuff Kits were then distributed to participating providers. Providers distributed the kits to patients meeting high-risk criteria for disease development, prioritizing those of racial/ethnic minorities. Surveys were distributed quarterly to providers and patients to assess HBPM perception., Results: 2910 Cuff Kits were distributed to patients at 179 sites in 14 states. Of those, 1160 were distributed to Black patients, 1045 to White patients, and 500 to Hispanic patients. 117 patients completed surveys, with most patients finding Cuff Kits "very valuable" or "valuable" (68.4% and 19.7%, respectively). Most providers (73.4%) felt the Cuff Kits influenced patient care., Conclusions: Most patients receiving Cuff Kits reported a beneficial impact on disease understanding and most belonged to racial/ethnic groups at higher risk of adverse outcomes. Providers found HBPM had a beneficial impact on care. Though more research is needed to illustrate the impact of HBPM on outcomes, this study suggests that among racial/ethnic minorities and those at the high risk, HBPM is a well-received intervention., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)