Short-term postpartum blood pressure self-management and long-term blood pressure control: a randomized controlled trial
Women with hypertensive pregnancies are 4× more likely to develop chronic hypertension. Previously, we showed a short period of blood pressure (BP) self-management following hypertensive pregnancy resulted in persistently lower BP after 6 months. We now report the impact on long-term BP control. Wom...
| المؤلفون الرئيسيون: | , , , , , , , , , , , , |
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| التنسيق: | Journal article |
| اللغة: | English |
| منشور في: |
American Heart Association
2021
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| _version_ | 1826311731058573312 |
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| author | Kitt, JA Fox, RL Cairns, AE Mollison, J Burchert, HH Kenworthy, Y McCourt, A Suriano, K Lewandowski, AJ Mackillop, L Tucker, KL McManus, RJ Leeson, P |
| author_facet | Kitt, JA Fox, RL Cairns, AE Mollison, J Burchert, HH Kenworthy, Y McCourt, A Suriano, K Lewandowski, AJ Mackillop, L Tucker, KL McManus, RJ Leeson, P |
| author_sort | Kitt, JA |
| collection | OXFORD |
| description | Women with hypertensive pregnancies are 4× more likely to develop chronic hypertension. Previously, we showed a short period of blood pressure (BP) self-management following hypertensive pregnancy resulted in persistently lower BP after 6 months. We now report the impact on long-term BP control. Women who participated in the postpartum randomized controlled trial, SNAP-HT (Self-Management of Postnatal Hypertension; NCT02333240), were invited for 24-hour ambulatory and clinic BP measures. Height and weight were measured by calibrated scales and standardized tape measures, activity by 7-day wrist-worn accelerometer, and dietary factors assessed by questionnaire. Sixty-one of 70 eligible women were followed up 3.6±0.4 years after their original pregnancy. Twenty-four–hour diastolic BP was 7.0 mm Hg lower in those originally randomized to postpartum BP self-management instead of usual care. This difference remained significant after adjustment for either BP at the time of delivery (−7.4 mm Hg [95% CI, −10.7 to −4.2]; P<0.001) or pregnancy booking BP (−6.9 mm Hg [95% CI, −10.3 to −3.6]; P<0.001). Adjustment for current salt intake, age, body mass index, waist-to-hip ratio, arm circumference, parity, alcohol intake, and physical activity had no effect on this difference. Reductions in diastolic BP at 6 months, following self-management of BP postpartum, are maintained 3.6 years later as measured by lower 24-hour diastolic BP. Interventions to optimize BP control during the puerperium in women with hypertensive pregnancies improve BP in the longer term, in a cohort at increased risk of developing chronic hypertension and major adverse cardiovascular events. |
| first_indexed | 2024-03-07T08:14:03Z |
| format | Journal article |
| id | oxford-uuid:64d8ee9d-18ba-469c-bd9c-81e6d5125d05 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:14:03Z |
| publishDate | 2021 |
| publisher | American Heart Association |
| record_format | dspace |
| spelling | oxford-uuid:64d8ee9d-18ba-469c-bd9c-81e6d5125d052023-12-18T14:34:31ZShort-term postpartum blood pressure self-management and long-term blood pressure control: a randomized controlled trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:64d8ee9d-18ba-469c-bd9c-81e6d5125d05EnglishSymplectic ElementsAmerican Heart Association2021Kitt, JAFox, RLCairns, AEMollison, JBurchert, HHKenworthy, YMcCourt, ASuriano, KLewandowski, AJMackillop, LTucker, KLMcManus, RJLeeson, PWomen with hypertensive pregnancies are 4× more likely to develop chronic hypertension. Previously, we showed a short period of blood pressure (BP) self-management following hypertensive pregnancy resulted in persistently lower BP after 6 months. We now report the impact on long-term BP control. Women who participated in the postpartum randomized controlled trial, SNAP-HT (Self-Management of Postnatal Hypertension; NCT02333240), were invited for 24-hour ambulatory and clinic BP measures. Height and weight were measured by calibrated scales and standardized tape measures, activity by 7-day wrist-worn accelerometer, and dietary factors assessed by questionnaire. Sixty-one of 70 eligible women were followed up 3.6±0.4 years after their original pregnancy. Twenty-four–hour diastolic BP was 7.0 mm Hg lower in those originally randomized to postpartum BP self-management instead of usual care. This difference remained significant after adjustment for either BP at the time of delivery (−7.4 mm Hg [95% CI, −10.7 to −4.2]; P<0.001) or pregnancy booking BP (−6.9 mm Hg [95% CI, −10.3 to −3.6]; P<0.001). Adjustment for current salt intake, age, body mass index, waist-to-hip ratio, arm circumference, parity, alcohol intake, and physical activity had no effect on this difference. Reductions in diastolic BP at 6 months, following self-management of BP postpartum, are maintained 3.6 years later as measured by lower 24-hour diastolic BP. Interventions to optimize BP control during the puerperium in women with hypertensive pregnancies improve BP in the longer term, in a cohort at increased risk of developing chronic hypertension and major adverse cardiovascular events. |
| spellingShingle | Kitt, JA Fox, RL Cairns, AE Mollison, J Burchert, HH Kenworthy, Y McCourt, A Suriano, K Lewandowski, AJ Mackillop, L Tucker, KL McManus, RJ Leeson, P Short-term postpartum blood pressure self-management and long-term blood pressure control: a randomized controlled trial |
| title | Short-term postpartum blood pressure self-management and long-term blood pressure control: a randomized controlled trial |
| title_full | Short-term postpartum blood pressure self-management and long-term blood pressure control: a randomized controlled trial |
| title_fullStr | Short-term postpartum blood pressure self-management and long-term blood pressure control: a randomized controlled trial |
| title_full_unstemmed | Short-term postpartum blood pressure self-management and long-term blood pressure control: a randomized controlled trial |
| title_short | Short-term postpartum blood pressure self-management and long-term blood pressure control: a randomized controlled trial |
| title_sort | short term postpartum blood pressure self management and long term blood pressure control a randomized controlled trial |
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