P-40: Home blood pressure measured telemetrically in hypertensive pregnant women

• Published in: American journal of hypertension Vol. 14; no. S1; pp. 42A - 43A
• Main Authors: Denolle, T., Weber, J. L., Calvez, C., Daniel, J. C., Cheve, M. T., Marechaud, M., Bessec, P., Carbonne, B., Gestin, Y., Gandon, J. M.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.04.2001
• Subjects: Home Blood Pressure; Pregnancy; Telemetry
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/S0895-7061(01)01518-7

Objectives To study: - the cost saving when using home blood pressure (HBP) measured telemetrically compared with classical BP monitoring in hypertensive pregnant women - the feasability of HBP during pregnancy - the prevalence of white coat hypertension (WCH) in mild hypertensive pregnant women. Design and methods After informed consent, 57 mild hypertensive women (81% nulliparous; 27 ±3 yrs with office BP ≥ 140/90 and ≤180/105mmHg and after 18 weeks' gestation: 29±5) without albuminuria or history of hypertension in previous pregnancies were taught in 8 hospitals by a nurse to control their BP at home with validated automatic oscillometric device (OMRON 705C). They underwent BP measurement 3 times before breakfast and after dinner in seated position during 7 days and checked urine for protein every day. After each session, the BP values were teletransmitted to TAM. After randomisation, TAM teletransmitted the results to the obstetrician (Group HBPT) or not (Group CM). But, when the mean of 3 successive values were > 160/100 mmHg, the obstetrician was alerted by TAM. The first two days measurements were excluded. HBP was validated if more than 22/30 measurements. Pregnant women with HBP < 117/73 and < 121/80 mmHg before and after 28 weeks'; gestation respectively were considered WCH. Results Cost saving: The number of visits, hospitalisations and other test were comparable in both groups as well as the birth weight and the frequency of cesarean delivery. Feasability: 86 % (42/49) HBP were validated with 27±3 teletransmitted measurements. 8 were excluded: 3 deliveries during HBP, 4 women were hospitalised (for 3 of these women, TAM alerted the obstetrician and the women were treated). One patient had no phone line. Only 7 (14%) did not control correctly their BP at home but 6/7 had 20 validated measurements or more. 92% of pregnant women found HBP easy to use. 3) The mean HBP was 117 ± 8/ 75 ± 8. The prevalence of WCH was 76% (32/42: 18 CM; 14 HBPT). Only 10 had probable hypertension (23 %). None presented preclampsia. Conclusion In pregnancy, WCH is very frequent. Telemetry to monitor BP at home is a feasible, safe and well tolerated alternative to repeated office visits or even hospitalization needed to confirm the diagnosis of permanent hypertension.