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Researchers at the Perelman School of Medicine at the University of Pennsylvania have launched a groundbreaking $12.5 million study aimed at improving postpartum blood pressure management and long-term cardiovascular health for patients with hypertensive disorders during pregnancy. The study, funded by the Patient-Centered Outcomes Research Institute (PCORI), is particularly focused on reducing racial disparities in maternal health, with Black women disproportionately affected by postpartum hypertension.
Postpartum hypertension, a leading cause of maternal complications in the United States, poses long-term risks for women, including an increased likelihood of chronic hypertension, heart attacks, or strokes later in life. While many individuals with pregnancy-related hypertension recover fully, the lasting impact on heart health remains a significant concern. The new study seeks to develop and evaluate patient-centered strategies for managing blood pressure after delivery, with the goal of improving outcomes for those most at risk.
The study, titled Self-Monitoring and Responsive Technology for Postpartum Blood Pressure Control (SMART Postpartum BP), will involve 670 patients across five hospitals in Pennsylvania, Ohio, and New York. Participants will test two telemedicine-based strategies for postpartum blood pressure management. The “low-touch” approach involves 10 days of home blood pressure monitoring following childbirth, with healthcare professionals reviewing the data and addressing concerning trends. The “high-touch” approach, on the other hand, involves 12 weeks of monitoring, with regular medication adjustments and frequent blood pressure measurements by pharmacists and nurses.
Principal investigator Jennifer Lewey, MD, MPH, director of the Penn Women’s Cardiovascular Center, emphasized the importance of addressing the challenges many patients face in accessing postpartum care. “Hypertension is a leading cause of maternal complications, yet many patients face challenges in accessing care during the postpartum period,” Lewey said. “This trial provides an opportunity to improve how we care for patients in this critical period and to address the longstanding disparities that affect maternal health outcomes.”
The SMART Postpartum BP study builds on the success of Penn Medicine’s previous initiatives aimed at improving postpartum cardiovascular care and reducing health inequities. One such program, Heart Safe Motherhood (HSM), developed by Penn’s Adi Hirshberg, MD, and Sindhu Srinivas, MD, has become a national model for postpartum care. HSM utilizes remote blood pressure cuffs and daily text-message reminders to monitor blood pressure at home. Data is sent to care teams who provide real-time feedback and interventions, such as prescribing medication or scheduling same-day appointments. A 2023 study found that patients using HSM experienced fewer seizures, strokes, emergency department visits, and hospital readmissions compared to those who did not participate in the program.
The SMART Postpartum BP study will assess blood pressure control, heart function, and patient-reported outcomes, such as stress and confidence in managing health, one year postpartum. The study aims to identify the most effective strategies for managing blood pressure and to ensure equitable care for all populations, particularly those who face barriers to in-person healthcare.
“Programs that allow patients to monitor their blood pressure from home represent a promising solution to one of the most pressing challenges in postpartum care,” said Lisa Levine, MD, MSCE, Director of Penn’s Pregnancy and Heart Disease Program and co-principal investigator of the study. “This study not only seeks to identify the most effective strategies but also examines how we can ensure equitable care across all populations.”
The SMART Postpartum BP study is expected to provide valuable insights into how telemedicine and patient-centered strategies can improve long-term cardiovascular health and reduce racial disparities in maternal care, ultimately helping to shape the future of postpartum healthcare.
