SNAP-HT EXTENSION STUDY
Research type
Research Study
Full title
SelfmaNAgement of Postnatal antiHypertensive Treatment (SNAP-HT) EXTENSION STUDY
IRAS ID
253692
Contact name
Paul Leeson
Contact email
Sponsor organisation
University of Oxford
ISRCTN Number
ISRCTN00000000
Clinicaltrials.gov Identifier
Duration of Study in the UK
0 years, 10 months, 1 days
Research summary
Summary of Research
During pregnancy some women develop high blood pressure (BP) which can affect their heart, brain, kidneys and the blood vessels. After pregnancy, blood pressure often settles but, the changes can persist and it's known that women who had high blood pressure in pregnancy are at higher risk of heart disease and stroke in later life. A recent trial (SNAP-HT) looked at whether the way blood pressure is managed, immediately after women have given birth, can be improved. The study had two groups: in one group the blood pressure was managed the normal way i.e. by their GP and midwife whilst the other group of women managed their own blood pressure at home using monitors provided by the research group and research doctors were updated on the women’s BP and adjusted medications using a mobile phone ‘app’.
The self-management group had better blood pressure control immediately after pregnancy but also six months later; even long after stopping medication. The aim is to now assess whether the improvement in the blood pressure, seen at 6 months, is still present now, approximately three years after giving birth, taking into account differences in diet, lifestyle, family history, levels of exercise and other confounding factors that may have arisen between the two groups.
This will be done by studying the same group of women from SNAP-HT and reassessing their blood pressure in detail at the current time-point (3-4 years since enrolment to the first trial) to see if the blood pressure difference is sustained. If so, it may suggest that self-management after birth can result in a sustained improvement in blood pressure which in turn could mean that self-management strategies should be considered in the guidelines for blood pressure management after pregnancy. It will also help define the study duration for future related research.Summary of Final report
Having high blood pressure during and immediately after pregnancy is associated with an increased risk of having heart attacks and strokes in later life. Whether this is beacuse of the way high blood pressure is managed around the time of pregnancy or just because the high blood pressure identifies women likely to have blood pressure problems at other times in life is not clear. We have previously shown in it is possible to improve blood pressure control immediately after prengnacy by helping the mothers monitor their own blood pressure and adjust their medication. In the current study we have followed up these mothers 3 or 4 years later to see whether this has led to long term improvement in blood pressure control for the mothers. We found that those women who managed their own blood pressure in the weeks after pregnancy continued to have lower blood pressure several years later, even though they were no longer necessarily on treatment.
REC name
South West - Frenchay Research Ethics Committee
REC reference
19/SW/0017
Date of REC Opinion
26 Mar 2019
REC opinion
Further Information Favourable Opinion