Persistent and de novo postpartum hypertension: a scoping review of pathophysiology, evaluation, and management

Postpartum hypertension is high blood pressure following delivery that may occur as persistent or de novo postpartum hypertension. This scoping review summarizes current evidence on the epidemiology, risk factors, evaluation, and management of postpartum hypertension and highlights areas for further investigation. Studies on persistent or de novo hypertension in the 12-month postpartum period were eligible for inclusion. Literature searches were performed in MEDLINE, Embase, and Scopus. Of 2132 studies screened, 116 met the inclusion criteria. Postpartum hypertension epidemiologic data are limited, in part due to the absence of a standardized definition. Distinct risk factors for persistent versus de novo disease suggest differing underlying pathophysiologic mechanisms, yet trials of postpartum antihypertensive therapies have not identified a clear first-line agent. While telemedicine interventions have demonstrated improvements in postpartum hypertension outcomes, standardization of diagnostic and treatment thresholds and expanded research into mechanisms and therapeutics for persistent and de novo disease are needed.