Self-Management of Postnatal HypertensionNovelty and Significance [Preeclampsia, Pregnancy, and Hypertension]
Hypertension affects 1 in 10 pregnancies, often persisting postpartum, when antihypertensive requirements may vary substantially. This unmasked, randomized controlled trial evaluated the feasibility and effects on blood pressure (BP) of self-management of postpartum hypertension. Women with gestational hypertension or preeclampsia, requiring postnatal antihypertensive treatment, were randomized to self-management or usual care. Self-management entailed daily home BP monitoring and automated medication reduction via telemonitoring. Women attended 5 follow-up visits during 6 months. The primary outcome was feasibility: specifically recruitment, retention, and compliance with follow-up rates. Secondary outcomes included BP control and safety, analyzed on an intention-to-treat basis. Forty-nine percent (91/186) of those women approached were randomized (45 intervention, 46 control), and 90% (82/91) finished follow-up. The groups had similar baseline characteristics. After randomization, BP was lower in the intervention group, most markedly at 6 weeks: intervention group mean (SD), systolic 121.6 (8.7)/diastolic 80.5 (6.6) mm Hg; control group, systolic 126.6 (11.0)/diastolic 86.0 (9.7) mm Hg; adjusted differences (95% confidence interval), systolic −5.2 (−9.3 to −1.2)/diastolic −5.8 (−9.1 to −2.5) mm Hg. Diastolic BP remained significantly lower in those self-managing to 6 months: adjusted difference −4.5 (−8.1 to −0.8) mm Hg. This is the first randomize...
Source: Hypertension - Category: Cardiology Authors: Alexandra E. Cairns, Katherine L. Tucker, Paul Leeson, Lucy H. Mackillop, Mauro Santos, Carmelo Velardo, Dario Salvi, Sam Mort, Jill Mollison, Lionel Tarassenko, Richard J. McManus, on behalf of the SNAP-HT Investigators Tags: Hypertension, Preeclampsia Original Articles Source Type: research