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

Abstract

AbstractObjectiveTo 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.DesignSingle‐blinded three‐arm randomised clinical trial.SettingTwo tertiary care hospitals and a community organisation.PopulationPostpartum overweight and obese individuals with a hypertensive disorder of pregnancy and without pre‐pregnancy hypertension or diabetes.MethodsWe 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.ResultsOver 23 months, we enrolled 148 of 400 eligible, screened individuals (37%); 28% black or other race and mean pre‐pregnancy body mass index (BMI) of 33.4 ± 6.7 kg/m2. 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.ConclusionIn 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.