Persistent Postpartum Hypertension Pilot Trial
Hypertension in Pregnancy
About this trial
This is an interventional treatment trial for Hypertension in Pregnancy
Eligibility Criteria
Inclusion Criteria:
- Antepartum diagnosis of gestational hypertension
- preeclampsia
- superimposed preeclampsia without antepartum chronic hypertension medication
- Delivery at 23 weeks or greater
- Persistent elevation in BP >24 hours postpartum (>140/90 mm Hg) (2 or more BP >4 hours apart)
- 18 years or older
- English speaking
Exclusion Criteria:
- Need for continuation of antepartum antihypertensive medication
- Contraindication of calcium channel blocker use
- Severe range (160/110 mm Hg) blood pressure requiring treatment >24 hours after delivery
- Requires a 2nd oral antihypertensive medication for blood pressure control inpatient
- Acute cardiomyopathy or heart failure
- Creatinine ≥1.5
- Blood pressure <90/60 within 24 hours of discharge
Sites / Locations
- Duke University
Arms of the Study
Arm 1
Arm 2
Other
No Intervention
Treatment Group
Control Group
The treatment group will be provided with month supply of 30mg tablets of nifedipine extended release prior to discharge from the delivery admission. Dose increases in clinic will be at the discretion of providers, however a treatment algorithm will be provided for guidance.Treatment group will be given a home blood pressure cuff prior to discharge with instructions for use. They will also be scheduled for a 1 week blood pressure check and 4 week postpartum clinic appointment which standard for these patients outside of this proposal.
The control group will not receive any medications at discharge. Providers will be instructed to only prescribe new blood pressure medication at subsequent postpartum visits if the blood pressure is in the severe range (>/=160/110). The control group will be given a home blood pressure cuff prior to discharge with instructions for use. They will also be scheduled for a 1 week blood pressure check and 4 week postpartum clinic appointment which standard for these patients outside of this proposal.