What question did this study set out to answer?

To evaluate whether blood pressure self-monitoring with telemonitoring leads to earlier clinical detection of hypertension in individuals with higher-risk pregnancies.

May 3, 2022JAMAOpen Access

Effect of Self-monitoring of Blood Pressure on Diagnosis of Hypertension During Higher-Risk Pregnancy

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Why the study?

Self-monitoring of blood pressure improves hypertension diagnosis in the general population, but little is known about its efficacy in pregnancy.

Does blood pressure self-monitoring with telemonitoring lead to earlier detection of pregnancy hypertension in pregnant individuals at higher risk of preeclampsia?

Key Points

To evaluate whether blood pressure self-monitoring with telemonitoring leads to earlier clinical detection of hypertension in individuals with higher-risk pregnancies.
Unblinded randomized clinical trial (NCT03334149) conducted across 15 hospital maternity units in England between November 2018 and October 2019, with follow-up through April 2020.
Enrolled 2,441 pregnant individuals at higher risk of preeclampsia recruited at a mean gestational age of 20 weeks.
Participants were randomized to self-monitoring of blood pressure with telemonitoring plus usual antenatal care (n = 1,223) or usual antenatal care alone (n = 1,218).
Of 2,441 randomized individuals, 2,346 (96%) completed the trial.
Time from randomization to first clinic-recorded hypertension was 104.3 (SD, 32.6) days in the self-monitoring group versus 106.2 (SD, 32.0) days in the usual care group (mean difference, -1.6 days; 95% CI, -8.1 to 4.9; P = .64).
Serious adverse events occurred in 12 participants (1%) in the self-monitoring group and 6 participants (0.5%) in the usual care group, with none deemed related to the intervention.

Structured PICO

Does blood pressure self-monitoring with telemonitoring lead to earlier detection of pregnancy hypertension in pregnant individuals at higher risk of preeclampsia?

Population

2441 pregnant individuals at higher risk of preeclampsia, recruited at a mean of 20 weeks' gestation, mean age 33 years, based in England.

Intervention

Blood pressure self-monitoring with telemonitoring plus usual care

Comparator

Usual antenatal care alone without access to telemonitored blood pressure

Outcome

Time to first recorded hypertension measured by a health care professionalsurrogate

Blood pressure self-monitoring with telemonitoring does not significantly reduce the time to clinic-based detection of hypertension in higher-risk pregnancies compared to usual care.

Discussion

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Implication

Self-monitoring BP did not improve early hypertension detection in high-risk pregnancy; challenges assumptions of benefit and leaves open optimal telemonitoring strategies.

Cite This Study

Tucker et al. (2022) studied this question.

synapsesocial.com/papers/6a83cd575dc7077fe9c58498 https://doi.org/10.1001/jama.2022.4712

Topics

Hypertension management

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Implication

Self-monitoring BP did not improve early hypertension detection in high-risk pregnancy; challenges assumptions of benefit and leaves open optimal telemonitoring strategies.

Effect of Self-monitoring of Blood Pressure on Diagnosis of Hypertension During Higher-Risk Pregnancy

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Effect of Self-monitoring of Blood Pressure on Diagnosis of Hypertension During Higher-Risk Pregnancy

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider