Important points:

• Long-term remote postpartum blood pressure monitoring was associated with improved blood pressure control after gestational hypertension.
• Program participants were more likely to follow up with their primary care physician.

ATLANTA — Implementing a remote postpartum blood pressure monitoring program for women with persistent hypertension after giving birth has been shown to be feasible and is associated with improved primary care provider attendance and blood pressure control, researchers say. reported by.

Gestational hypertension is associated with high rates of postpartum hypertension, with data showing that half of women have persistent hypertension six weeks postpartum. Aneesha R. Reddy medical doctor, The University of Pittsburgh Medical Center resident said this during a moderated poster theater session at the American College of Cardiology’s Scientific Sessions. Researchers assessed the feasibility of a text-based remote blood pressure management program that leverages existing postpartum telemonitoring programs to extend blood pressure monitoring from six weeks to up to one year.

At the end of the one-year extension program, 92% of participants had blood pressure below 140/90 mmHg, compared to 71% of participants at the end of the six-week program, Reddy said.

Aneesha R. Reddy

“Hypertensive disorders of pregnancy often lead to postpartum hypertension,” Reddy told Healio. “Some people are not receiving treatment during the puerperium because it is difficult to get to the clinic in person. This can lead to chronic hypertension and an increased risk of cardiovascular disease. We wanted to design an innovative way to monitor it.”

Reddy et al. analyzed data from 1,318 women who participated in an enhanced remote blood pressure monitoring program and 2,344 women who participated in the same program only up to 6 weeks postpartum.

“Our program initially offered six weeks of remote blood pressure monitoring, but we found that approximately 50% of women were receiving suboptimal hypertension treatment at the end of the six-week period.” Reddy told Healio. [the program] Up to 1 year. ”

Women eligible for the telemonitoring program had persistent hypertension, defined as requiring ongoing antihypertensive medication and/or having a blood pressure >130/90 mm Hg 3 weeks postpartum. Ta. The average age of participants was 33 years. Twenty-two percent of participants were black, and 32% had public insurance.

hatred Cantoli

“Patients will receive a text message reminder with a link to a webpage where they can enter their blood pressure.” hatred CantoliM.D., M.S. said Helio, assistant professor of medicine and co-director of the Postpartum Hypertension Program at the University of Pittsburgh Medical Center. “We want to make treatment as easy as possible for our patients. Participants also had the opportunity to download an app to help optimize the number of people reaching their blood pressure levels.”

After choosing extended monitoring, 61% of participants entered at least one blood pressure measurement (mean 57 blood pressures entered) and participated for a median of 23 weeks postpartum. At the end of the extended monitoring program, the final mean blood pressure in the extended group was 121/79 mmHg compared with 125/82 mmHg at the end of the 6-week program.

The extension group had a higher rate of PCP follow-up within 18 months postpartum compared with the 6-week program group (46% vs. 39%; P .001), and visits to postpartum hypertension clinics also increased (20% vs. 2%; P .001).

Reddy said the data show that monitoring blood pressure beyond the first six weeks postpartum may address gaps in care and reduce CV risk. Reddy noted that even within a robust program, only a small number of participants with persistent hypertension participate in extended monitoring and receive PCP visits, and that ongoing efforts to address care are essential. He emphasized the importance of innovative approaches.

“We were able to capture a very racially and socio-economically diverse population,” Reddy said. “We need to assess the barriers some of these patients face to follow-up with his PCP. Are they struggling with logistics, such as scheduling? To the patient Isn’t there enough education?

Kantoris said the data shows that remote monitoring can improve blood pressure in postpartum women.

“Several [the lower BPs at 1 year] This may be due to recovery over time, but we suspect that much of it is related to participation in the program. There is an opportunity to optimize the number of participants. At 6 weeks, only about 40% of women with persistent hypertension are still participating in extended monitoring. We need to encourage more people to participate. ”

Issuer:

Information source/disclosure information

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sauce:

Reddy AR et al. Summary 1021-11. Presentation location: American College of Cardiology Scientific Sessions. April 6-8, 2024. Atlanta.

Disclosure: Countouris and Reddy do not report any relevant financial disclosures.

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