Main findings
We demonstrate feasibility and
high retention in a randomized trial of postpartum home blood pressure
monitoring plus a lifestyle intervention among a diverse sample of
overweight and obese individuals with HDP. Importantly, while our study
is not powered to show a statistical difference in efficacy, we note
that home blood pressure monitoring and home blood pressure monitoring
plus our lifestyle intervention arms had lower mean arterial blood
pressure compared to controls at one-year postpartum and we detected
statistically significant decreases in sodium consumption associated
with the full intervention. We also demonstrate a high proportion of
participants with ongoing hypertension at one-year postpartum, with over
half meeting criteria for stage 1 hypertension, over 20% with stage 2
hypertension and 10% of participants still requiring anti-hypertensive
agents. We showed no statistical difference in weight change across
study arms, suggesting that any changes in blood pressure were not
secondary to weight loss in the intervention arms. Particularly relevant
in this population of overweight and obese participants is the
significant weight retention at one-year postpartum, with less than 30%
of individuals returning to their pre-pregnancy weight by study
completion.