Abstract
Importance: Hypertension is increasingly common in pregnancy capable individuals, yet there is limited data on antihypertensive medication dispensation in peripartum individuals. Objective: To describe antihypertensive medication dispensation from preconception through the first year postpartum. Design, Setting, and Participants: This retrospective cohort study used the Truven Health Market Scan administrative data from 2008 to 2014 to identify women in the United States with commercial or government health insurance, aged 15-54, free from heart disease, who experienced a pregnancy and filled at least 1 prescription for an antihypertensive medication between 3 months prior to conception and 12 months after the end of the pregnancy. Main Outcomes and Measures: We describe antihypertensive dispensation patterns (continuation, initiation, and discontinuation) by medication class during 5 time periods: preconception, first, second, and third trimesters, and the first year postpartum. Results: Of 1,058,521 pregnancies, 108,614 (10.3%) were exposed to at least 1 antihypertensive medication dispensation. The most commonly dispensed medications across all periods combined were adrenergic blockers, calcium channel blockers (CCBs), and diuretics. Renin-angiotensin-aldosterone system (RAAS) inhibitors were the third most dispensed medication class in the preconception period (26.4%), and fills decreased to 5.7% and 1.7% in the second and third trimesters, respectively. Of the women with chronic hypertension who filled at least 1 prescription prior to conception, 8.4% were not dispensed an antihypertensive medication during the first year after delivery. Conclusions and Relevance: Antihypertensive prescription dispensation of both preferred and potentially harmful agents is common in pregnancy capable individuals. Patterns of dispensation suggest room for improvement in the treatment of chronic hypertension after a pregnancy.
Original language | English (US) |
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Pages (from-to) | 5-13 |
Number of pages | 9 |
Journal | American heart journal |
Volume | 278 |
DOIs | |
State | Published - Dec 2024 |
Funding
Data were de-identified, and this work was deemed exempt by the Columbia University Institutional Review Board. To preserve confidentiality, categories that included fewer than 20 pregnancies were not further specified. This work was supported by the following grants \u2013 Bello: NIH/NHLBI K23 HL136853; Miller: NIH/NINDS K23 NS107645. The authors are solely responsible for the design and conduct of this study, all study analyses, the drafting and editing of the paper and its final contents.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine