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Postpartum home blood pressure monitoring and lifestyle intervention in overweight and obese individuals the first year after gestational hypertension or pre‐eclampsia: A pilot feasibility trial

Alisse Hauspurg, Ellen W. Seely, Janet W. Rich‐Edwards, Christina Hayduchok, Samantha Bryan, Andrea T. Roche, Arun Jeyabalan, Esa M. Davis, Renee Hart, Jada Shirriel, Janet M. Catov

2023BJOG An International Journal of Obstetrics & Gynaecology27 citationsDOIOpen Access PDF

Abstract

OBJECTIVE: To test the feasibility of a randomised trial of home blood pressure monitoring paired with a remote lifestyle intervention (Heart Health 4 New Moms) versus home blood pressure monitoring alone versus control in individuals with a hypertensive disorder of pregnancy in the first year postpartum. DESIGN: Single-blinded three-arm randomised clinical trial. SETTING: Two tertiary care hospitals and a community organisation. POPULATION: Postpartum overweight and obese individuals with a hypertensive disorder of pregnancy and without pre-pregnancy hypertension or diabetes. METHODS: We assessed the feasibility of recruitment and retention of 150 participants to study completion at 1-year postpartum with randomisation 1:1:1 into each arm. Secondary aims were to test effects of the interventions on weight, blood pressure and self-efficacy. RESULTS: . In total, 129 (87%) participants completed the 1-year postpartum study visit. Overall, 22% of participants developed stage 2 hypertension (≥140/90 mmHg or on anti-hypertensive medications) by 1 year postpartum. There were no differences in weight or self-efficacy across the study arms. CONCLUSION: In this pilot, randomised trial, we demonstrate feasibility of HBPM paired with a lifestyle intervention in the first year postpartum. We detected high rates of ongoing hypertension, emphasising the need for the development of effective interventions in this population.

Topics & Concepts

MedicineOverweightBlood pressureBody mass indexPregnancyPopulationGestational diabetesObstetricsGestational hypertensionPhysical therapyRandomized controlled trialDiabetes mellitusPreeclampsiaInternal medicineGestationEndocrinologyEnvironmental healthGeneticsBiologyPregnancy and preeclampsia studiesBlood Pressure and Hypertension StudiesGestational Diabetes Research and Management