Postpartum HEART: Hypertension Education, Awareness, Risk Reduction, and Transitions of Care

The Postpartum HEART program aims to improve long-term cardiovascular outcomes for approximately 1,200 patients diagnosed with hypertensive disorders of pregnancy (HDP) in rural Mercer and Venango Counties by optimizing transitions from obstetrics care to primary care. Through remote monitoring, virtual visits, and proactive eConsults, the initiative addresses significant health disparities and aligns with HRSA goals to enhance care in underserved communities.

Partially funded by: Health Resources & Services Administration

Funding Amount: $1,196,119

Project Duration: 4 years

Project Collaborators at UPMC: Magee Women’s Health Service Line, UPMC Horizon, UPMC Northwest, UPMC Primary Care Network, Adagio Health, and Pennsylvania Association of Community Health Centers.

Research Location: Project activities are conducted both in-person and virtually with individuals who live in, give birth in, or provide support to patients in Mercer and Venango Counties in rural Pennsylvania.

 

Background: Hypertensive disorders of pregnancy (HDP)—including preeclampsia, gestational hypertension, and chronic hypertension—affect 15% of U.S. pregnancies[1], with significantly higher rates in rural areas, and are a major contributor to maternal mortality and long-term cardiovascular disease, particularly among underserved populations[2],[3],4],[5] . These conditions often persist postpartum and are exacerbated in rural areas by limited access to care, social determinants of health, and lifestyle factors, underscoring the urgent need for improved transitions from obstetric care to primary care for effective hypertension management and cardiovascular disease prevention[6]. This work will be co-designed with various stakeholders from and implemented in Mercer and Venango counties, which rank among the lowest in county health outcomes in Pennsylvania and face significant healthcare access challenges—making targeted support for postpartum hypertension vital to improving long-term cardiovascular health in these underserved rural communities.

Healthcare challenge: There is a critical gap in postpartum care for individuals with HDP, leading to elevated risks of severe maternal morbidity and mortality, fragmented transitions from obstetric care to primary care, and inconsistent delivery of guideline-based cardiovascular care.

Goals: Key goals include the development of a care continuum for patients who participate in a 6-week post-partum HDP remote patient monitoring program, the development of a Virtual Care Center to provide cardiovascular disease prevention education and facilitate connection to primary care, and the creation of proactive eConsults to support guideline-based cardiovascular care delivery by primary care providers.

Implementation Approach:

Population: Women with a diagnosis of HDP who deliver at UPMC Horizon in Mercer County and UPMC Northwest in Venango County, two rural counties in Pennsylvania.

Methodology: This project will utilize a combination of design, implementation, and evaluation strategies to develop and assess Postpartum HEART processes and workflows. Key methods include conducting community needs assessments, engaging stakeholders—particularly through focus groups with women in the communities and the Rural Maternal Health Advisory Committee—collecting and analyzing qualitative and quantitative data, and applying implementation supports such as Plan-Do-Study-Act (PDSA) cycles to refine and optimize program delivery.

This project is supported by an award from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

Cited References

[1] Ford ND, Cox S, Ko JY, et al. Hypertensive Disorders in Pregnancy and Mortality at Delivery Hospitalization - United States, 2017-2019. MMWR Morb Mortal Wkly Rep. Apr29 2022;71(17):585-591. doi:10.15585/mmwr.mm7117a1

[2] Lo CCW, Lo ACQ, Leow SH, et al. Future Cardiovascular Disease Risk for Women WithGestational Hypertension: A Systematic Review and Meta-Analysis. J Am Heart Assoc. Jul 7 2020;9(13):e013991.

[3] Visser VS, Hermes W, Franx A, et al. High blood pressure six weeks postpartum after hypertensive pregnancy disorders at term is associated with chronic hypertension. Pregnancy Hypertens. Oct 2013;3(4):242-7.

[4] Greiner KS, Speranza RJ, Rincón M, Beeraka SS, Burwick RM. Association between insurance type and pregnancy outcomes in women diagnosed with hypertensive disorders of pregnancy. J Matern Fetal Neonatal Med. Apr 2020;33(8):1427-1433.

[5] Francis B, Pearl M, Colen C, Shoben A, Sealy-Jefferson S. Racial and Economic Segregation Over the Life Course and Incident Hypertensive Disorders of PregnancyAmong Black Women in California. Am J Epidemiol. Feb 5 2024;193(2):277-284.

[6] Freiha M, Sosso J, Kattah A. Hypertensive Disorders of Pregnancy: Reaching the Rural Population After Delivery. Curr Hypertens Rep. Aug 2025;27(1):23.