Spironolactone to Improve Pregnancy-Associated Hypertension Trajectories
The hypertensive disorders of pregnancy (preeclampsia and gestational hypertension) are associated with increased long-term maternal risk of developing cardiovascular disease. Recent evidence suggests that activation of the mineralocorticoid receptor promotes ongoing susceptibility to hypertension in women following hypertensive disorders of pregnancy. In addition, women with overweight/obesity are at increased risk for progression to chronic hypertension after experiencing hypertensive disorders of pregnancy. Among women with hypertensive disorders of pregnancy and pre-pregnancy overweight/obesity, the investigators will conduct a randomized trial to test the effect of pharmacologically blocking the mineralocorticoid receptor for three months after delivery on blood pressure and cardiac remodeling at nine months postpartum.
• Females aged ≥18 years
• Antepartum-onset HDP (gestational hypertension or preeclampsia) without pre-pregnancy chronic hypertension
• BMI ≥25 kg/m2 prior to pregnancy or in the first trimester
• Requirement for antihypertensive medication on postpartum discharge
• Ability to provide informed consent