Pre-eclampsia is a serious condition which affects up to 6% of pregnancies, and a key early sign is high blood pressure. Although the condition usually goes away after childbirth, there is a huge increase in the risk of coronary heart disease later in life for women if they had pre-eclampsia.
“At the moment, these women are really well managed in pregnancy and in hospital, and then once their blood pressure comes down, they are sent home, and only followed up with a blood pressure check every few weeks, or not at all,” says Professor Paul Leeson from the CCRF.
“Then, a few years later, they will come back with hypertension (high blood pressure) and further changes to their heart and their brain, which are more difficult to manage. But if we manage these mothers really well in the early stages after birth, could we reduce future risk?”
How an app is helping mothers manage their blood pressure
Professor Leeson has already run a small study in collaboration with Professor Richard McManus, also at the University of Oxford, who is an expert in developing ways patients can manage their own blood pressure.
A smartphone app, designed by a team from the university’s Institute of Biomedical Engineering with input from the Department of Obstetrics, responded to the blood pressure readings by giving personalised instructions on how best to adjust their medications. Six months later, their blood pressure was lower than the group of women who received usual care.
Professor Leeson says: “The difference was on average about 5mm of mercury (mmHg) lower.” (Healthy blood pressure is below 120/80mmHg.) “
That changes your trajectory significantly: it is enough to mean that you may develop hypertension several years later than you would have done, or that you don’t develop it at all
- Professor Paul Leeson
Six months later, their blood pressure was lower than the group of women who received usual care.
“This only needs to last for one to two months after pregnancy,” says Professor Leeson. “It is attractive as an idea because it is quite a short-term technique that could have long-term benefits.”
The second aspect of the research involves returning to the women involved in the first small study, to see if their blood pressure has remained lower three to four years later. The team will also look at changes in the bodies of women who have experienced pre-eclampsia.
They have previously looked at the heart and circulatory system five to 10 years after preeclampsia – some were found to have enlarged hearts (which puts them at risk of heart problems such as heart failure) and even changes in their brains.
“We looked at changes in blood vessels in the brain, years after the pregnancy, and there is damage linked to higher blood pressure, which means they are at increased risk of stroke and vascular dementia,” says Professor Leeson.
The BHF-funded research will continue this work in more detail, looking at changes to the blood vessels of the heart, brain and eyes. For the first time in this research, they are studying the blood vessels at the back of the eyes, because they are closely linked to the small blood vessels in the brain and may provide new information about how pre-eclampsia affects women’s bodies.
Read the full article on the BHF website.
Original source: BHF.