Health Care News, Uncategorized

Self-Measured Blood Pressure Monitoring During and After Pregnancy

By Eleni Tsigas, CEO, Preeclampsia Foundation

Hypertension in pregnancy and the postpartum period can be deadly. Preeclampsia, eclampsia, and HELLP syndrome comprise a set of complex disorders that contribute greatly to maternal morbidity and mortality and are a leading cause of premature birth and neonatal death. May is High Blood Pressure Education Month, the same month we recognize Preeclampsia Awareness Month.

Of the signs and symptoms of preeclampsia, high blood pressure (BP) is the reason the American College of Obstetrics and Gynecology (ACOG) and the US Preventative Services Task Force recommend BP monitoring throughout pregnancy, as well as at least a week postpartum for women who experienced any form of hypertension in pregnancy or antepartum period. We posit that all women with any risk factors – such as autoimmune disorders, obesity, and personal or family history of preeclampsia – should monitor their BP during these time periods.

The COVID-19 pandemic forced many prenatal and postpartum health care visits to be conducted via telehealth, essentially putting the onus of BP checks on mothers – often without the proper equipment or know-how to take and report accurate readings.

In response, the Preeclampsia Foundation developed and deployed the Cuff Kit™ — a validated blood pressure monitor and specially created patient education – in print and online, with pictures, video, and written explanations on how to take your blood pressure at home, measurement logs, and a postpartum ‘bracelet’ to help women — and their providers — remember that they are still at risk after delivery. Distribution is prioritized to high-risk, marginalized and vulnerable populations.

Nearly a year later, here is what we are finding.

With the support of these Cuff Kits™, most women are taking their BP at home – 65% daily. 78% are reviewing their logs with their providers – either via telehealth or in person.

Patients overwhelming (90%) found taking BP at home valuable.  They all found the instructions and education that was provided helpful.

And 84% of providers are reporting that the Cuff Kit has influenced their patient care.

Self-Measured Blood Pressure (SMBP) with telehealth protocols such as Heart Safe Motherhood and STAMMP HTN have been shown to improve several outcomes including:

  • Eliminating racial disparities in postpartum monitoring
  • Drastically improved show rates for those who need to be seen, and
  • Reduced resource use for women who do not need to be seen

Other studies have found BP readings taken at home by high-risk women are accurate and useful; and in pregnancy SMBP has the potential to be useful in the early detection of gestational hypertensive disorders but may require ongoing patient support and enhanced training. Research is still needed to measure the impact of self-measured blood pressure on health outcomes.

There are several mobile apps, commercial products, and protocols emerging to facilitate home blood pressure monitoring; though they do not all count on patient reporting – some are automatically reading and delivering results to providers.  

Community health centers are a good place for patients to seek help when wanting to get started on self-measuring their blood pressure regardless of pregnancy.

Here is a thought. Could owning your own BP cuff in these formative years also set a woman on a path toward lifelong awareness and monitoring of her blood pressure? BP is an important indicator of wellness, a factor of even greater importance to preeclampsia survivors who are significantly increased risk of developing cardiovascular disease later in life.

We think so.

To learn more visit www.preeclampsia.org/the-cuff-project.

Learn more about NACHC’s work with the Million Hearts® project including what we are doing for blood pressure control: https://www.nachc.org/clinical-matters/nachc-million-hearts-initiative/.

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