New mothers who had hypertension in pregnancy could reduce their risk of heart attack, stroke and potentially early death through daily blood pressure checks at home, research suggests.
Women who regularly monitored their blood pressure in the weeks after giving birth, and had doctors tailor their medication if needed, had better functioning arteries nine months later than those who received routine care, scientists found.
When the medication was adjusted to account for blood pressure changes, the women ended up with less stiff arteries, an effect that researchers at the University of Oxford estimate could reduce the future risk of heart attack or stroke by 10%.
Paul Leeson, a professor of cardiovascular medicine who led the study, said the findings suggested that the weeks after birth provided a “powerful and often overlooked opportunity” to protect women’s future health.
“By simply monitoring blood pressure at home, new mothers with hypertensive pregnancies can protect their bodies from future damage,” he said. He hoped the work would pave the way for wider use of home monitoring so that more women could benefit.
High blood pressure, in the form of gestational hypertension or pre-eclampsia, where there are signs of organ damage, affects 5-10% of pregnant women. The condition can damage the mother’s organs and endanger the baby’s life.
Beyond the immediate threat to mother and baby, hypertension in pregnancy can raise the risk of long-term problems, with women three times more likely to develop high blood pressure and twice as likely to have heart disease later in life. In one study, Harvard researchers found that high blood pressure in pregnancy was linked to a 42% rise in the risk of premature death.
The Oxford team recruited 220 women who developed hypertension in pregnancy. All were on blood pressure medication but were due to reduce their dosage and eventually stop taking the drugs.
In the study, 108 women had standard care in which their medication was reduced based on a few blood pressure checks in the eight weeks after giving birth. The remaining 112 women used a monitor to check their blood pressure at home each day. They plugged the readings into an app shared with doctors who, if needed, changed their medication day to day, with the aim of giving them better control of the blood pressure.
The new approach, reported in Hypertension, led to much better control of the women’s blood pressure, and in tests six to nine months later the women had less stiff arteries. Stiff arteries are less effective at expanding and contracting, which can drive high blood pressure and ultimately the formation of clots that can block blood vessels and cause heart attacks and strokes.
Trials are now under way to find effective ways of rolling out blood pressure monitoring to women after hypertensive pregnancies. One option is for specialist NHS clinics to deliver the care.
Dr Sonya Babu-Narayan, the clinical director at the British Heart Foundation, which funded the work, said the results highlighted a crucial window after birth when paying close attention to blood pressure could help protect women’s heart health for years to come.
“We now look forward to seeing results from larger studies with longer follow-up to see how this might save women’s lives,” she said. “Research like this highlights the significance of the recently renewed women’s health strategy, reflecting the importance of heart health advice and care at key points across a woman’s life, from periods and pregnancy to menopause and beyond.”
