Self-monitoring blood pressure (BP) during the early postpartum period may take advantage of a "critical window" when better BP monitoring could prevent later cardiovascular events in women who have hypertensive pregnancies, new research suggests.
In a randomized trial of 220 women with preeclampsia or gestational hypertension, those who took daily postpartum BP readings and received clinician-guided advice for titrating antihypertensives had a 5 mm Hg lower average diastolic BP at 9 months, compared with those receiving usual care.
Jamie Kitt, DPhil, from the University of Oxford, Oxford, England, presented these findings from the Physicians Optimized Postpartum Hypertension Treatment (POP-HT) clinical trial at the American Heart Association (AHA) 2023 Scientific Sessions. The study was simultaneously published online in JAMA, and a cardiac imaging substudy was published online in Circulation.
"This trial identifies a potential need for a paradigm shift in the way women affected by hypertensive pregnancy are managed postnatally," Kitt said. "If a 5 mm Hg improvement in BP is maintained longer term, it can result in about a 20% reduction in lifetime cardiovascular risk."
The imaging substudy suggests that short-term postnatal optimization of BP control following hypertensive pregnancy through self-monitoring and physician-guided antihypertensive titration is linked with better cardiac remodeling changes seen by cardiovascular magnetic resonance and echocardiography.
