85. Is home blood pressure monitoring in Hypertensive Disorders of Pregnancy consistent with clinic recordings?

Abstract

Objectives To assess the agreement of home blood-pressure monitoring (HBPM) and office blood pressure measurements in a cohort of pregnant women with Hypertensive Disorders of Pregnancy (HDP). Methods This was a cohort study at St George’s Hospital. The inclusion criteria were chronic hypertension, gestational hypertension or high risk of developing preeclampsia, no significant proteinuria and no hematological or biochemical abnormalities. The blood pressure measurements at home and the corresponding hospital visit for that gestational age were coupled for analysis. Differences between home and office blood pressure measurements were tested using Wilcoxon signed rank test or paired t-test and they were also visually assessed with Bland-Altman plots. Subgroup analyses were performed in the following gestational age windows: Results A total of 294 blood pressure measurements from 147 women were included in the analysis. The systolic HBPM measurements were significantly lower than office measurements [median (IQR): 132.0 mmHg (123.0–140.0 mmHg) vs 138.0 mmHg (132.0–146.5 mmHg), p Conclusions HBPM has the potential to reduce unnecessary medical interventions in women with HDP, but this must be carefully weighed against the risk of increasing adverse outcomes. Prospective studies investigating the use of HBPM in pregnant women are urgently needed to determine the relevant thresholds and monitoring frequency.