Poster Presentation Society of Obstetric Medicine of Australia and New Zealand and Australasian Diabetes in Pregnancy Society Joint Scientific Meeting 2017

Home Blood Pressure Measurement in Women with Pregnancy-related Hypertensive Disorders (#116)

Patrick G Lan 1 2 , Jonathan Hyett 3 4 , Adrian G Gillin 1 2
  1. Sydney Medical School, University of Medicine, Sydney, NSW, Australia
  2. Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
  3. Central Clinical School, University of Sydney, Sydney, NSW, Australia
  4. Department of Obstetrics and Gynaecology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia

Introduction: Home blood pressure measurement (HBPM) is being increasingly used in the general adult population for the diagnosis and management of hypertension. This is a result of HBPM being better correlated to clinical outcomes compared to clinic blood pressure (BP) measurement, and the increasing availability of automated BP measuring devices. However, its use in pregnancy is unclear, and current clinical practice is still based upon hospital or clinic assessment of the women’s blood pressure. Currently there is no evidence available that assesses the reliability or utility of HBPM.

Objective: To determine if HBPM provides comparable results to clinic BP measurement.

Methods: A prospective, single-centre study of 46 pregnant and early post-partum women with a hypertensive pregnancy or at high-risk of developing a hypertensive pregnancy. Study participants were asked to perform HBPM for a minimum period of one week. This was subsequently compared to clinic BP measurement both before and after the period of home measurement.

Results: The HBPM was found to be comparable to clinic measurements [for the systolic blood pressure (SBP), the mean home reading was 125.0mmHg (95% CI: 123.5-126.5mmHg) versus 123.9mmHg (95% CI: 121.3-126.5mmHg) for the clinic reading (p=0.37); for the diastolic blood pressure (DBP) the mean home reading was 82.2mmHg (95% CI: 81.0-83.3mmHg) versus 84.4mmHg (95% CI: 82.6-86.2mmHg) for the clinic (p<0.01)]. There were no reported issues associated with the use of HBPM, and it did lead to 5 women contacting health care professionals for management of their BP between clinic visits.

Conclusions: HBPM provides comparable results to the clinic BP measurement. It is also an acceptable technique for pregnant and early post-partum women. However, it cannot at this present stage replace clinic visits or clinic BP measurement.