Effect of intervention weight and blood pressure
There were no statistical differences in weight, BMI at follow up visit or weight change from enrollment by study arm (Table 3). Overall, participants retained a mean of 9.5 ± 18.5 pounds above their pre-pregnancy weight. Thirty-eight (29%) participants were back to their pre-pregnancy weight by study completion. HBPM plus HH4NM intervention led to a greater but not statistically significant decrease in systolic, diastolic and mean arterial pressure (MAP) between the two study visits (Table 3) when compared to HBPM alone and control [mean change in MAP (95%CI) -3.7(-6.5, -0.9), -0.4(-6.6, 1.0), -1.0(-4.1, 2.2) mmHg], respectively. Differences in SBP and DBP were similar. Overall, 75 (58%) participants met criteria for stage 1 hypertension or greater and 28 (22%) met criteria for stage 2 hypertension with 13 (10%) participants on anti-hypertensive medication at one-year postpartum with no difference by study arm. Because of the small sample size, the arms appeared to be less balanced by race and type of HDP. Post-hoc, we examined whether these factors may have influenced our findings. Adjustment for type of hypertensive disorder and race did not change our estimates.