CTSA News

UI researchers will investigate remote blood pressure monitoring to address a crucial gap in postpartum care.

Researchers with the University of Iowa (UI) Institute for Clinical and Translational Science (ICTS) have launched a three-part project to improve screening and diagnosis of high blood pressure (hypertension) in postpartum women living in rural areas, with the long-term goal of improving treatment of this dangerous condition in this population.

Hypertension is a common but underrecognized and undertreated health concern for women following the birth of their child.

A recent study found that more than 20 weeks after delivery, almost four out of 10 postpartum women had high blood pressure. In addition, women who had elevated blood pressure throughout pregnancy had the highest risk of having stage 1 or 2 hypertension.

This study emphasized what researchers with ICTS already knew: postpartum women need hypertension care, and an improved standard of care is necessary for diagnosing, managing, and treating hypertension in these women.

When left untreated, hypertension can lead to coronary artery disease, heart failure, stroke, mild cognitive impairment, and more. In pregnant women, high blood pressure can be even more dangerous. It can cause seizures, stroke, temporary kidney failure, liver problems, and blood clotting disorders. Pregnant women with high blood pressure also have a higher risk of needing a C-section in delivery.

Building the path toward better diagnosis and treatment   

The multidisciplinary team includes UI researchers and medical providers with expertise in women’s health, preeclampsia, statistical methods, pediatric care, hypertension, and home blood pressure measurements using novel methods. The team includes Philip Polgreen, M.D., Linnea Polgreen, Ph.D., Mark Santillan, M.D., Ph.D., Alberto Segre, Ph.D., Rachel Hoskins, Pharm.D., Shelby Francis, Ph.D., and Joe Cavanaugh, Ph.D.

The new project will consist of three phases. Each will focus on postpartum women living in rural areas who have a history of high blood pressure. 

The first phase, which is currently in progress, will determine which of three methods is the best for remotely collecting blood pressure readings from the women. Participants will be given a blood pressure monitor and assigned a method for providing the data to the research team. Participants will either text their values to the research team, send an image of the values, or use a Bluetooth blood pressure monitor that automatically sends the data to the research team.

After the data are collected, the team will move to the second phase, using the data to determine the best frequency for collecting blood pressure readings to ensure timely detection of high blood pressure.

These two phases in tandem will help the team develop an effective intervention strategy using remote blood pressure monitoring to ensure postpartum women at risk for hypertension can be diagnosed in a timely fashion and get the care they need to maintain healthy blood pressure. 

Meeting new mothers where they are  

The team is also using an innovative approach for recruiting participants to the study that meets new mothers where they are. With the help of Hao Tran, M.D., a UI clinical professor of pediatrics, the researchers identified new mothers who matched the participant requirements and visited them while they were in the pediatric clinic for a well-child visit.

“Postpartum women often ignore their own health and even ignore their own health care visits, but they regularly bring their children for well-child visits,” Tran shared. This recruitment strategy allows new mothers to participate in the project and take a step towards taking care of their health, without requiring an extra visit to the doctor's office.

Overall, the study aims to bridge the gap between birth and long-term care for mothers who may be at risk of developing hypertension in the future.

“We are passionate about finding new ways to help these women obtain the care they need,” says Shelby Francis, a member of the research team.