60. Blood pressure after PREeclampsia/HELLP by SELF monitoring (BP-PRESELF): Rationale and design of a multicenter randomized controlled trial

Abstract

Background Hypertensive pregnancy disorders (HPD) such as preeclampsia (PE) or the hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome are associated with an elevated cardiovascular disease (CVD) risk. Standardized prevention guidelines after pregnancy in these high-risk women are lacking. Hypertension is the first emerging risk factor after PE/HELLP pregnancies and is acknowledged as a major risk factor for CVD. Premature hypertension leads to various manifestations of end-organ damage at young age. Timely treatment of elevated blood pressure is mandatory, despite many of these women have long-term undetected and untreated hypertension before adequate treatment is initiated. Hypothesis The aim of our study is to assess whether home blood pressure monitoring (HBPM) in women with a previous pregnancy with PE/HELLP is a valuable tool for early detection of hypertension. Methods Women with a history of PE/HELLP syndrome (both early and late) aged 40–60 years are invited to participate. They are randomized between HPBM or ‘usual care’. Patients with a history of CVD, known hypertension and/or use of antihypertensive medication are excluded. The primary outcome is to evaluate feasibility and usability of HBPM after 1 year of follow-up. Secondary outcomes will be to assess the effectiveness of blood pressure (BP) home monitoring to detect hypertension, the efficacy of BP treatment, quality of life (QoL), health-related symptoms, work ability and life-style behaviour. Discussion The results of this study will provide information for optimal preventive strategies to detect hypertension in women after PE/HELLP.