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Background: Hypertension remains the leading risk factor for cardiovascular disease in women, and those who have a hypertensive disorder of pregnancy are at particular risk. We aimed to determine whether peripartum interventions for hypertension are associated with long-term cardiovascular risk. Methods: statistic. Robustness was examined using leave-one-out sensitivity analyses, funnel plots, and Egger's test for small-study effects. GRADE was used to assess the certainty of evidence. The study is registered with PROSPERO, CRD42024581604. Findings: =0%) blood pressure within 1 year postpartum. Blood pressure data were insufficient to perform a meta-analysis on lifestyle interventions. Few studies reported on cardiovascular structure and function although improved diastolic function was consistently reported. Clinical outcomes were rarely reported, which led to small sample sizes and low statistical power. Following the GRADE assessment, there was moderate certainty on the effect of antenatal pharmaceutical and nutraceutical therapy and remote blood pressure management on postpartum blood pressure outcomes and limited confidence (low-quality evidence) supporting postnatal pharmaceutical and nutraceutical therapy. Interpretation: There is a paucity of evidence around peripartum interventions and their effect on modifying cardiovascular risk through blood pressure reduction. There were no high-quality randomised controlled trials reporting long-term outcomes. Future research, with longer follow-up of cardiovascular outcomes or validated surrogate measures of cardiovascular disease, are needed to identify optimal peripartum interventions to reduce risk. Funding: None.
Frost et al. (Fri,) studied this question.