Post-partum intervention lowers BP after hypertensive pregnancy 

The POP-HT study demonstrated that blood pressure (BP) interventions in the first weeks after pregnancy have the potential to yield long-term benefits following a hypertensive pregnancy. Improving post-partum BP control has a positive influence on the mid-long term, which appears to persist after medication is stopped. 

“Although hypertensive disorders of pregnancy are associated with an increased risk of cardiovascular disease, there are no proven therapies to reduce the post-partum risk,” according to Dr Jamie Kitt (University of Oxford, UK) [1]. The POP-HT study (NCT04273854) randomised 220 women with gestational hypertension or pre-eclampsia 1:1 to standard NHS care in the control group or the intervention arm, in which self-monitored BP readings were sent to a physician who subsequently optimised BP medication for the respective participants [1,2]. The primary endpoint was the 24-hour mean diastolic BP at approximately 9 months post-partum.

At 9 months post-partum, the between-group 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) [1]. Likewise, the difference in 24-hour mean systolic BP was -6.5 mmHg, favouring the intervention arm (95% CI -4.2 to -8.8). “Furthermore, there were 29 BP-related re-admissions in the control arm versus 8 in the intervention arm, meaning that we need to treat 5 individuals to avoid 1 BP-related post-natal re-admission,” 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 [1,2].

1. 
   
   1. Kitt J, et al. Physician optimized postpartum hypertension treatment (POP-HT) randomised trial. LB04, AHA Scientific Sessions 2023, 11–13 November, Philadelphia, USA.
   2. Kitt J, et al. J. Am. Med. Assoc. 2023;330(20):1991–1999.

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Posted on 29 January, 202429 January, 2024