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HypertensionSecondary analysis

Cardiac Remodeling After Hypertensive Pregnancy Following Physician-Optimized Blood Pressure Self-Management: The POP-HT Randomized Clinical Trial Imaging Substudy

CirculationPublished

  • Secondary analysis of the POP-HT randomised trial
  • prospective
  • open-label
  • blinded end point
  • single UK hospital
  • imaging substudy
Read the original article ↗

Authors' conclusion

Short-term postnatal optimization of blood pressure control after hypertensive pregnancy, through self-monitoring and physician-guided antihypertensive titration, associates with long-term changes in cardiovascular structure and function, in a pattern associated with more favorable cardiovascular outcomes.

Study context

Population
Women ≥18 years with preeclampsia or gestational hypertension requiring antihypertensives on hospital discharge postnatally187 had echo at baseline and follow-up
Participants
220 women
Comparison
Intervention vs Usual care
Primary endpoint
Prespecified secondary cardiac imaging outcomes:
  • Echocardiography
  • CMR at follow-up
Follow-up
Around 9 months postpartum

Primary result

As reported in the abstract

Cardiac remodelling by echocardiography (baseline to follow-up) and CMR (follow-up) · mean 258±14.6 days postpartum
Intervention vs Usual careDifference, g/m2 (95% CI)P value
LV mass by CMR
−6.37(−7.99 to −4.74)
P < 0.001
Intervention vs Usual careDifference, mL/m2 (95% CI)P value
end-diastolic volume by CMR
−3.87(−6.77 to −0.98)
P = 0.009
Intervention vs Usual careDifference, % (95% CI)P value
LVEF, higher with intervention
2.6(1.3–3.9)
P < 0.001
RVEF, higher with intervention
2.8(1.4–4.1)
P < 0.001
relative wall thickness by echocardiography, lower with intervention
difference 0.06 (95% CI 0.07–0.05); P < 0.001
end-systolic volume by CMR
difference −3.25 mL/m² (95% CI 4.87 to −1.63); P < 0.001
Average E/E' by echocardiography, mean difference 0.52 (95% CI, −0.97 to −0.07) between baseline and follow-up, adjusted for baseline differences
P = 0.024
Left atrial volumes by echocardiography, reduction of −4.33 mL/m² (95% CI, −5.52 to −3.21) between baseline and follow-up, adjusted for baseline differences
P < 0.001

Original publication

Cardiac Remodeling After Hypertensive Pregnancy Following Physician-Optimized Blood Pressure Self-Management: The POP-HT Randomized Clinical Trial Imaging Substudy. Circulation. Published 11 November 2023. doi:10.1161/circulationaha.123.067597
Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it