BP intervention saves lives of hypertensive pregnant women

The POP-HT study is the first randomised trial to show that blood pressure (BP) interventions in the first weeks after pregnancy may yield long-term benefits in hypertensive pregnant women. Improving postpartum BP control has a positive influence on the mid-long term, which appears to persist after medication is stopped.

Dr Jamie Kitt (University of Oxford, UK) and co-investigators randomised 220 women with gestational hypertension or preeclampsia 1:1 to the control group, in which the women received standard NHS care, or the intervention arm, in which self-monitored BP readings were sent to a physician who subsequently optimised BP medication for the respective participants. The primary endpoint was the 24-hour mean diastolic BP at approximately 9 months postpartum.

At 9 months, the difference in 24-hour mean diastolic BP was -5.8, favouring the intervention arm over the control arm (95% CI -4.2 to -7.4). Likewise, the difference in 24-hour mean systolic BP was -6.5 mmHg, in favour of the intervention arm (95% CI -4.2 to -8.8). “Furthermore, there were 29 BP re-admissions in the control arm and 8 BP-related re-admissions in the intervention arm, meaning that we need to treat 5 individuals to avoid 1 BP-related postnatal readmission,” added Dr Kitt.

According to Dr Kitt, the results of this trial are clinically meaningful. “A 5 mmHg improvement in BP would result in a 20% reduction in lifetime cardiovascular risk if this improvement is maintained in the long-term,” he concluded.

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   1. Kitt J, et al. Physician optimized postpartum hypertension treatment (POP-HT) randomised trial. LB04, AHA Scientific Sessions 2023, 10–12 November, Philadelphia, USA.

 

Medical writing support was provided by Robert van den Heuvel.
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Posted on 14 November, 202315 November, 2023