Guideline-directed management and therapy (GDMT) for the prevention of postpartum cardiac dysfunction in preeclamptic African American women

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Project Summary/Abstract African American women are 60% more likely to have postpartum hypertension and are nearly three times more likely to die from preeclampsia than white women. Both during pregnancy and overall, hypertension in African American women is more severe and presents earlier in life. In addition, compared to other ethnic- racial groups, African American women have higher mortality rates from hypertension-related end-organ damage like heart failure and stroke. Currently, however, no proven interventions exist to prevent or mitigate the development of hypertensive heart disease during the postpartum period. Using a randomized mechanistic clinical trial of guideline-directed medical therapy for postpartum African American women with preeclampsia, we will advance knowledge of cardiac dysfunction in preeclampsia and its possible treatments. We pursue a specific aim to answer these questions. AIM 1 is a randomized trial to test whether guideline-directed medical therapy improves cardiac function and decreases blood pressure in postpartum African American women with preeclampsia. This project innovates methodologically to dramatically advance our understanding of a significant cause of morbidity and mortality in African American women.