Managing postnatal hypertension: is a self-monitoring protocol more effective?

This study investigated if self-management of hypertension is effective and feasible in postpartum women.

They found that self-management improved blood pressure control and is a feasible treatment protocol for postpartum women with hypertension.

During pregnancy many women can experience hypertensive conditions (high blood pressure) including pre-eclampsia. Hypertension can persist in some women after pregnancy (postpartum).

Home blood pressure (BP) monitoring and self-management has been shown to be very effective in managing hypertension in the nonpregnant population. It is unclear if this is feasible and effective in managing postpartum hypertension.

This study investigated if self-management of BP is feasible and effective in postpartum women.

This study included 91 patients with postpartum hypertension. Patients were randomly assigned to either a self-management protocol or standard postnatal care. Self-management involved using a blood pressure monitor to record daily BP at home and readings were sent via text message to an online server. If normal BP was maintained for 5 consecutive days patients continued to take their prescribed dose of medication and monitor BP daily. If changes in BP were recorded, readings were automatically analyzed and patients received a text message instructing them on how to adjust their medication to regulate their BP. Both self-management and standard care patients had 5 follow-up home visits over a 6-month period and BP was measured.

Women that self-managed BP had a lower average BP level compared to women that received standard care. Patients in the self-management group were more likely to reach the target BP range at 6 weeks postpartum. Over 90% of women in the self-management group followed the protocol accurately throughout the trial.

The authors concluded that self-management improved blood pressure control and is a feasible treatment protocol for postpartum women with hypertension.

This study included a relatively small number of patients. The women in this study were primarily white and middle-class. Factors such as ethnicity and socioeconomic status (class) can influence the feasibility of self-management protocols. Further investigation in a more diverse population is needed.

If you have any concerns regarding managing postpartum blood pressure then please consult with your physician.