# Managing cardiovascular disease risk among women with hypertensive disorders in pregnancy: a mixed method analysis of system factors influencing the postpartum transition to primary care

> **NIH NIH R56** · UNIVERSITY OF MASSACHUSETTS AMHERST · 2020 · $468,034

## Abstract

PROJECT SUMMARY
Cardiovascular disease (CVD) is the leading cause of death among women in the United States. Women who
experience hypertensive disorders in pregnancy (HDP), including chronic hypertension, gestational
hypertension, and pre-eclampsia/eclampsia, are at substantially higher future CVD risk. Although increased
risk of CVD after pre-eclampsia was identified in the 1960s, little attention has been paid to whether women
with HDP receive appropriate care accounting for the increased CVD risk. Maternity and postpartum care offer
critical points of access to the health care system, especially for low-income and underinsured women who
gain insurance coverage during pregnancy and childbirth. Women with HDP require ongoing management of
CVD risk across the lifecourse, and the postpartum period is a unique window of opportunity to engage women
in primary care to improve outcomes. Despite low rates of postpartum transition to primary care for CVD risk
management for women with HDP, little is known about the impact of patient and system factors on this
transition. We use a mixed methods approach to examine patient, insurance, clinician, and organizational
characteristics influencing the postpartum transition to primary care for women with HDP. The specific aims
are: 1) to determine the role of patient and insurance characteristics in the postpartum primary care transition
for women with HDP; 2) to determine the role of clinician and organizational characteristics in the postpartum
primary care transition for women with HDP; and 3) to explore the process of transition from obstetric care to
primary care in the postpartum year from the perspectives of women with HDP and clinicians Efforts are
ongoing to incorporate pregnancy risk factors into existing CVD risk calculators and to develop guidelines for
care specific to women with a history of HDP. However, for primary care guidelines to be successful in
improving the health of women at high risk for CVD, we must first ensure that the transition to primary care
occurs in the postpartum period. Findings from this study will provide essential information to guide future
improvements in the postpartum care transition for women with HDP by contributing to the identification of
process improvements and policy levers that will improve the quality of care and clinical practice.

## Key facts

- **NIH application ID:** 10241718
- **Project number:** 1R56HL151636-01
- **Recipient organization:** UNIVERSITY OF MASSACHUSETTS AMHERST
- **Principal Investigator:** Laura B Attanasio
- **Activity code:** R56 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $468,034
- **Award type:** 1
- **Project period:** 2020-09-25 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10241718

## Citation

> US National Institutes of Health, RePORTER application 10241718, Managing cardiovascular disease risk among women with hypertensive disorders in pregnancy: a mixed method analysis of system factors influencing the postpartum transition to primary care (1R56HL151636-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10241718. Licensed CC0.

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