Rutgers, The State University of New Jersey
We hypothesize that frequent remote monitoring of blood pressure and real-time antihypertensive medication titration will optimize pregnancy outcomes in a clinically meaningful and cost-effective manner compared to the current standard of care. Therefore, this pilot study, as part of the K12 training support, will evaluate the feasibility of a randomized clinical trial to treat mild chronic hypertension with medication therapy to a blood pressure goal of less than 140/90 mmHg based on remote daily patient monitoring compared to in-office blood pressure readings.
Hypotheses / Research Question(s) Specific Aim 1: To evaluate whether remote patient blood pressure monitoring during the antepartum period for patients with chronic hypertension will improve composite perinatal outcomes. Hypothesis: In patients with chronic hypertension, tight blood pressure control with remote patient monitoring will improve composite outcomes. Participants in the two trial arms will be compared for the frequency of composite perinatal outcomes (perinatal death, placental abruption, superimposed preeclampsia with severe features, or indicated preterm birth \<35 weeks). Compl…
Inclusion Criteria: * Age 18 or older * Patients with a viable pregnancy \<23 weeks of gestation * Chronic hypertension is defined as: 1) Currently receiving treatment for hypertensive disorders OR 2) Newly diagnosed or untreated chronic hypertension is defined as systolic blood pressure \>=140 mm Hg or diastolic blood pressure \>=90 mm Hg prior to 20 weeks of gestation * Viable pregnancy \<23 weeks of gestation * Ability to follow directions * Ability to consent * Speak English or Spanish Exclusion Criteria: * Known secondary cause of hypertension * Known major fetal anomaly * Known fetal…
The patients randomized to this intervention will get set up with remote patient monitoring. For these patients, blood pressure management and medication adjustment will be based on remote blood pressure measurements.
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