Key result
Elevated UPCR linked to ~4.9-fold higher risk of postpartum resistant hypertension in severe preeclampsia.
Why the study?
The association between an elevated urine protein-to-creatinine ratio and resistant hypertension during postpartum hospitalization in patients with severe preeclampsia required investigation.
Is an elevated urine protein-to-creatinine ratio (≥0.3) associated with an increased risk of resistant hypertension during postpartum hospitalization in patients with severe preeclampsia?
Cohort (n=261)
No
Is an elevated urine protein-to-creatinine ratio (≥0.3) associated with an increased risk of resistant hypertension during postpartum hospitalization in patients with severe preeclampsia?
An elevated urine protein-to-creatinine ratio (≥0.3) is independently associated with a nearly five-fold increased risk of developing resistant hypertension during postpartum hospitalization in patients with severe preeclampsia.
Answers are grounded in this paper and cite their sources.
May support closer postpartum BP monitoring in severe preeclampsia with elevated UPCR; leaves open whether targeted interventions reduce resistant hypertension.
OBJECTIVE: Our objective was to investigate the association between elevated urine protein-to-creatinine ratio (UPCR) and resistant hypertension during postpartum hospitalization in patients with severe preeclampsia at a tertiary care center in Colombia. METHODS: This retrospective cohort study was conducted in Medellín, Colombia. Patients aged >18 years diagnosed with severe preeclampsia who underwent UPCR assessment were included. Associations between elevated UPCR (≥0.3) and resistant hypertension during postpartum hospitalization were evaluated using robust Poisson regression models. RESULTS: A total of 261 patients were included in the study. Bivariate analysis showed that resistant hypertension in the postpartum period was more frequent in the UPCR ≥0.3 group than in the UPCR <0.3 group (43.2% vs. 12.7%; risk ratio 3.69; 95% confidence interval 1.92-7.07). After adjustment for maternal age, body mass index, and gestational age at diagnosis, elevated UPCR remained independently associated with resistant hypertension (adjusted risk ratio 4.87; 95% confidence interval 1.86-12.76). Earlier gestational age at diagnosis was also independently associated with resistant hypertension. CONCLUSION: The UPCR is independently associated with the development of resistant hypertension during postpartum hospitalization in patients with severe preeclampsia.
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Annicchiarico et al. (2026) conducted a cohort in Severe preeclampsia (n=261). Elevated urine protein-to-creatinine ratio (UPCR ≥0.3) vs. UPCR <0.3 was evaluated on Resistant hypertension during postpartum hospitalization (aRR 4.87, 95% CI 1.86-12.76). Elevated UPCR (≥0.3) was independently associated with postpartum resistant hypertension in patients with severe preeclampsia (43.2% vs 12.7%; aRR 4.87; 95% CI 1.86-12.76).
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