{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:17:20Z","timestamp":1788182240435,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["R21NR020857"],"award-info":[{"award-number":["R21NR020857"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adherence to blood pressure (BP) evaluation 7\u201310 days after pregnancy complicated by hypertension is poor. Current guidelines for postpartum BP control are more liberal than those for nonpregnant individuals. Our objective was to determine whether a comprehensive BP management program and tight BP control improve BP outcomes at 7\u201310 days postpartum compared with clinician\u2010directed management and standard targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Postpartum patients with chronic or gestational hypertension, preeclampsia\/eclampsia, or HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome were randomized simultaneously to two interventions (four arms total): (1a) comprehensive management with remote BP monitoring and algorithm\u2010based treatment, (1b) clinician\u2010directed management at the primary obstetric provider's discretion, and (2a) tight (&lt;140\/90\u00a0mmHg) versus (2b) standard (&lt;150\/100\u00a0mmHg) BP control. Outcomes were measured at 7\u201310 days postpartum; the primary outcome was in\u2010office BP evaluation and secondary outcomes included BP ascertainment (remote or in\u2010person), BP change from baseline, antihypertensive medication initiation, any BP \u2265140\/90\u00a0mmHg or \u2265160\/110\u00a0mmHg, and all\u2010cause emergency department visits or hospital readmissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From May 9, 2023 to August 1, 2024, 334 of 660 eligible participants were randomized. There was no difference for the primary outcome of in\u2010person BP visit attendance between the comprehensive and clinician\u2010directed management interventions (62.5% [\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0105\/168] vs. 52.4% [\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a087\/166]; adjusted odds ratio [aOR], 1.50, 95% confidence interval [CI], 0.94\u20132.39). Comprehensive management increased any BP ascertainment (remote or in\u2010person) compared with clinician management (91.7% [\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0154\/168] vs. 57.2% [\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a095\/166]; aOR, 9.23, 95% CI, 4.76\u201317.91). Among participants randomized to tight control, comprehensive management reduced systolic BP compared with clinician management (\u22121.8\u00a0\u00b1\u00a016.5 vs. 5.7\u00a0\u00b1\u00a016.4\u00a0mmHg; adjusted beta coefficient, \u22129.23; 95% CI, \u221214.46 to \u22124.00). For participants in comprehensive management, tight control increased odds of medication initiation compared with standard control (32.1% [\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a017\/53] vs. 8.2% [\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a04\/49]; aOR, 4.25, 95% CI, 1.17\u201315.48).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A comprehensive postpartum BP management program with coaching and remote monitoring did not improve in\u2010person BP visit attendance at 7\u201310 days postpartum but did increase odds of patients reporting any BP to a clinician. Findings from the secondary outcomes suggest that a tight BP target combined with the comprehensive BP management program reduced systolic BP and increased the odds of initiating new antihypertensives by 10 days postpartum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70145","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T12:54:43Z","timestamp":1765544083000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comprehensive blood pressure management to improve early postpartum blood pressure parameters: A randomized controlled trial"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6560-4249","authenticated-orcid":false,"given":"Alexandra J. D.","family":"Phelps","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6689-8245","authenticated-orcid":false,"given":"Jinyuan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn J.","family":"Lindley","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiovascular Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6549-094X","authenticated-orcid":false,"given":"Julia C.","family":"Phillippi","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Nursing  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Webb","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loveis","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilly","family":"He","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashanti E.","family":"Griggs\u2010Cooks","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Dudipala","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soha S.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Etoi","family":"Garrison","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah S.","family":"Osmundson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal\u2010Fetal Medicine Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7117a1"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2018.01.012"},{"key":"e_1_2_12_4_1","article-title":"Pregnancy Mortality Surveillance System","author":"CDC","year":"2024","journal-title":"Maternal Mortality Prevention"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.07.002"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001642"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2024.1389"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2022.11.009"},{"key":"e_1_2_12_9_1","doi-asserted-by":"crossref","unstructured":"Hypertension in pregnancy.2013.Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. 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