Does remote blood pressure monitoring improve blood pressure ascertainment within 10 days of discharge in postpartum patients with hypertensive disorders of pregnancy?
Remote blood pressure monitoring significantly improves postpartum blood pressure ascertainment rates in patients with pregnancy-related hypertension and eliminates racial disparities seen with in-office follow-up.
OBJECTIVE: To compare the rate of blood pressure ascertainment within 10 days of postpartum discharge among individuals with hypertensive disorders of pregnancy randomized either to in-office blood pressure assessment or at-home monitoring. METHODS: This was a multisite randomized controlled trial of postpartum patients diagnosed with a hypertensive disorder of pregnancy before discharge between April 2021 and September 2021 and was performed at two academic training institutions. Patients were randomized to either an in-office blood pressure check or remote monitoring through a web-enabled smartphone platform. The primary outcome was the rate of any blood pressure ascertainment within 10 days of discharge. Secondary outcomes include rates of initiation of antihypertensive medication, readmission, and additional office or triage visits for hypertension. Assuming a 10-day postdischarge blood pressure ascertainment rate of 50% in the in-office arm, we estimated that 186 participants would provide 80% power to detect a 20% difference in the primary outcome between groups. RESULTS: One hundred ninety-seven patients were randomized (96 remote, 101 in-office). Patients with remote monitoring had higher rates of postpartum blood pressure ascertainment compared with in-office surveillance (91.7% n=88 vs 58.4% n=59; P.99). CONCLUSION: Remote monitoring can increase postpartum blood pressure ascertainment within 10 days of discharge for women with hypertensive disorders of pregnancy and has the potential to promote health equity. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT04823949.
Arkerson et al. (Thu,) studied this question.