Self-monitoring of BP failed to diagnose preeclampsia early in high-risk pregnancies: JAMA

Blood pressure self-monitoring with telemonitoring, as compared to standard treatment, did not result in significantly earlier clinic-based identification of hypertension in pregnant women at higher risk of preeclampsia, says an article published in the Journal of American Medical Association.

Inadequate treatment of high blood pressure (BP) is a major contributor to maternal mortality. Self-monitoring of blood pressure has been demonstrated to enhance hypertension diagnosis and therapy in the general population; however, little is known regarding its utility during pregnancy. As a result, Katherine L. Tucker and colleagues undertook this study to see if self-monitoring of blood pressure in high-risk pregnancies leads to early diagnosis of pregnant hypertension.

Randomized, unblinded clinical research including 2441 pregnant women at increased risk of preeclampsia who were recruited at a mean of 20 weeks' gestation from 15 hospital maternity units between November 2018 and October 2019. The last follow-up was finished in April 2020. Individuals in the study were randomly assigned to receive BP self-monitoring with telemonitoring (n = 1223) with normal care or usual prenatal care alone (n = 1218) without access to telemonitored BP. The primary outcome was the time it took for a health care practitioner to detect hypertension for the first time.

The key findings of this study were a follow:

1. The experiment was completed by 2346 (96%) of the 2441 randomized individuals.

2. The period from randomization to clinic hypertension recording was not substantially different between persons in the self-monitoring group and those in the usual care group.

3. During the experiment, eighteen significant adverse events were recorded, but none were deemed to be connected to the intervention (12 [1% ] in the self-monitoring group vs 6 [0.5% ] in the usual care group).

In conclusion, blood pressure self-monitoring with telemonitoring compared to usual care did not result in increased earlier clinic-based detection of hypertension in pregnant women at higher risk of preeclampsia.

Reference:

Tucker, K. L., Mort, S., Yu, L.-M., Campbell, H., Rivero-Arias, O., Wilson, H. M., Allen, J., Band, R., Chisholm, A., Crawford, C., Dougall, G., Engonidou, L., Franssen, M., Green, M., (2022). Effect of Self-monitoring of Blood Pressure on Diagnosis of Hypertension During Higher-Risk Pregnancy. In JAMA (Vol. 327, Issue 17, p. 1656). American Medical Association (AMA). https://doi.org/10.1001/jama.2022.4712