{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T04:18:13Z","timestamp":1792815493443,"version":"4.5.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"crossref","award":["FS\/19\/7\/34148"],"award-info":[{"award-number":["FS\/19\/7\/34148"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"crossref"}]},{"name":"NIHR | NIHR Oxford Biomedical Research Centre"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2024,2,13]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Hypertensive pregnancy disorders are associated with adverse cardiac remodeling, which can fail to reverse in the postpartum period in some women. The Physician-Optimized Postpartum Hypertension Treatment trial demonstrated that improved blood pressure control while the cardiovascular system recovers postpartum associates with persistently reduced blood pressure. We now report the effect on cardiac remodeling.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>In this prospective, randomized, open-label, blinded end point trial, in a single UK hospital, 220 women were randomly assigned 1:1 to self-monitoring with research physician-optimized antihypertensive titration or usual postnatal care from a primary care physician and midwife. Participants were 18 years of age or older, with preeclampsia or gestational hypertension, requiring antihypertensives on hospital discharge postnatally. Prespecified secondary cardiac imaging outcomes were recorded by echocardiography around delivery, and again at blood pressure primary outcome assessment, around 9 months postpartum, when cardiovascular magnetic resonance was also performed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              A total of 187 women (101 intervention; 86 usual care) underwent echocardiography at baseline and follow-up, at a mean 258\u00b114.6 days postpartum, of which 174 (93 intervention; 81 usual care) also had cardiovascular magnetic resonance at follow-up. Relative wall thickness by echocardiography was 0.06 (95% CI, 0.07\u20130.05;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001) lower in the intervention group between baseline and follow-up, and cardiovascular magnetic resonance at follow-up demonstrated a lower left ventricular mass (\u20136.37 g\/m\n              <jats:sup>2<\/jats:sup>\n              ; 95% CI, \u20137.99 to \u20134.74;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001), end-diastolic volume (\u20133.87 mL\/m\n              <jats:sup>2<\/jats:sup>\n              ; 95% CI, \u20136.77 to \u20130.98;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.009), and end-systolic volume (\u20133.25 mL\/m\n              <jats:sup>2<\/jats:sup>\n              ; 95% CI, 4.87 to \u20131.63;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001) and higher left and right ventricular ejection fraction by 2.6% (95% CI, 1.3\u20133.9;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001) and 2.8% (95% CI, 1.4\u20134.1;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001), respectively. Echocardiography-assessed left ventricular diastolic function demonstrated a mean difference in average E\/E\u2019 of 0.52 (95% CI, \u20130.97 to \u20130.07;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.024) and a reduction in left atrial volumes of \u20134.33 mL\/m\n              <jats:sup>2<\/jats:sup>\n              (95% CI, \u20135.52 to \u20133.21;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.001) between baseline and follow-up when adjusted for baseline differences in measures.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Short-term postnatal optimization of blood pressure control after hypertensive pregnancy, through self-monitoring and physician-guided antihypertensive titration, associates with long-term changes in cardiovascular structure and function, in a pattern associated with more favorable cardiovascular outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT04273854.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.123.067597","type":"journal-article","created":{"date-parts":[[2023,11,11]],"date-time":"2023-11-11T15:30:13Z","timestamp":1699716613000},"page":"529-541","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":80,"title":["Cardiac Remodeling After Hypertensive Pregnancy Following Physician-Optimized Blood Pressure Self-Management: The POP-HT Randomized Clinical Trial Imaging Substudy"],"prefix":"10.1161","volume":"149","clinical-trial-number":[{"clinical-trial-number":"nct04273854","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3247-5126","authenticated-orcid":true,"given":"Jamie","family":"Kitt","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine (J.K., S.K., A.F., K.S., Y.K., W.L., A.J.L., P.L.), University of Oxford, United Kingdom."},{"name":"Nuffield Department of Primary Care Health Sciences (J.K., K.T., P.A.B., R.J.M.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3671-6978","authenticated-orcid":true,"given":"Samuel","family":"Krasner","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine (J.K., S.K., A.F., K.S., Y.K., W.L., A.J.L., P.L.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3856-9289","authenticated-orcid":true,"given":"Logan","family":"Barr","sequence":"additional","affiliation":[{"name":"Queen\u2019s University School of Medicine, Kingston, Canada (L.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabelle","family":"Frost","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine (J.K., S.K., A.F., K.S., Y.K., W.L., A.J.L., P.L.), University of Oxford, United Kingdom."},{"name":"Nuffield Department of Women\u2019s and Reproductive Health (A.F., L.M., A.C., C.A.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6544-8066","authenticated-orcid":true,"given":"Katherine","family":"Tucker","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences (J.K., K.T., P.A.B., R.J.M.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0626-7809","authenticated-orcid":true,"given":"Paul A.","family":"Bateman","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences (J.K., K.T., P.A.B., R.J.M.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Suriano","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine (J.K., S.K., A.F., K.S., Y.K., W.L., A.J.L., P.L.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Kenworthy","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine (J.K., S.K., A.F., K.S., Y.K., W.L., A.J.L., P.L.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3703-0735","authenticated-orcid":true,"given":"Winok","family":"Lapidaire","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine (J.K., S.K., A.F., K.S., Y.K., W.L., A.J.L., P.L.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7282-6894","authenticated-orcid":true,"given":"Miriam","family":"Lacharie","sequence":"additional","affiliation":[{"name":"Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine (M.L., R.M., S.P.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Mills","sequence":"additional","affiliation":[{"name":"Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine (M.L., R.M., S.P.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Roman","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering, Department of Engineering Science (C.R.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1927-1594","authenticated-orcid":true,"given":"Lucy","family":"Mackillop","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women\u2019s and Reproductive Health (A.F., L.M., A.C., C.A.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6989-0887","authenticated-orcid":true,"given":"Alexandra","family":"Cairns","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women\u2019s and Reproductive Health (A.F., L.M., A.C., C.A.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6260-6740","authenticated-orcid":true,"given":"Christina","family":"Aye","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women\u2019s and Reproductive Health (A.F., L.M., A.C., C.A.), University of Oxford, United Kingdom."},{"name":"Fetal Medicine Unit, Oxford University Hospitals National Health Service Foundation Trust, United Kingdom (C.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0046-7634","authenticated-orcid":true,"given":"Vanessa","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Oxford Centre for Clinical Magnetic Resonance Research (V.F., E.L.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0268-5221","authenticated-orcid":true,"given":"Stefan","family":"Piechnik","sequence":"additional","affiliation":[{"name":"Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine (M.L., R.M., S.P.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1729-8918","authenticated-orcid":true,"given":"Elena","family":"Lukaschuk","sequence":"additional","affiliation":[{"name":"Oxford Centre for Clinical Magnetic Resonance Research (V.F., E.L.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5531-4301","authenticated-orcid":true,"given":"Basky","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George\u2019s University Hospitals National Health Service Foundation Trust, London, United Kingdom (B.T.)."},{"name":"Molecular and Clinical Sciences Research Institute, St George\u2019s University of London, United Kingdom (B.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6219-3379","authenticated-orcid":true,"given":"Lucy C.","family":"Chappell","sequence":"additional","affiliation":[{"name":"King\u2019s College London and Guy\u2019s and St Thomas\u2019 National Health Service Foundation Trust, United Kingdom (L.C.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4978-8965","authenticated-orcid":true,"given":"Adam J.","family":"Lewandowski","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine (J.K., S.K., A.F., K.S., Y.K., W.L., A.J.L., P.L.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3638-028X","authenticated-orcid":true,"given":"Richard J.","family":"McManus","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences (J.K., K.T., P.A.B., R.J.M.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9181-9297","authenticated-orcid":true,"given":"Paul","family":"Leeson","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine (J.K., S.K., A.F., K.S., Y.K., W.L., A.J.L., P.L.), University of Oxford, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.176537"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.07.028"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpregu.00762.2001"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.895458"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.17410"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.116.004888"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.110.162321"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.013545"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2020.00059"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004351.pub3"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018696"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpz182"},{"key":"e_1_3_3_14_2","unstructured":"National Institute for Health and Care Excellence (NICE). Hypertension in pregnancy: diagnosis and management. NG133 2019. Accessed November 11 2023. https:\/\/www.nice.org.uk\/guidance\/ng133"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.03.019"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.18123"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.21523"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-051180"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1530\/ERP-19-0050"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.05.053"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1993.tb15104.x"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12968-015-0111-7"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-12-65"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-12-69"},{"key":"e_1_3_3_26_2","first-page":"38","article-title":"World Health Organization, WHO International Working Group For Drug Statistics Methodology, World Health Organization. WHO Collaborating Center For Drug Statistics Methodology. WHO Collaborating Center For Drug Utilization Research And Clinical Pharmacological Services.","year":"2003","unstructured":"World Health Organization, WHO International Working Group For Drug Statistics Methodology, World Health Organization. WHO Collaborating Center For Drug Statistics Methodology. WHO Collaborating Center For Drug Utilization Research And Clinical Pharmacological Services. Introduction to Drug Utilization Research. World Health Organization; 2003:38\u201341.","journal-title":"Introduction to Drug Utilization Research"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00966.2001"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e3283300541"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.113.01319"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.3310\/eme08120"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.122.18730"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6818e1"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.10911"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.17101"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.15875"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1177\/1753944716642677"},{"key":"e_1_3_3_37_2","volume-title":"Hypertension in pregnancy: the management of hypertensive disorders during pregnancy","author":"National Collaborating Centre for Women's and Children's Health (UK)","year":"2010","unstructured":"National Collaborating Centre for Women's and Children's Health (UK). Hypertension in pregnancy: the management of hypertensive disorders during pregnancy. RCOG Press; 2010."},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002188"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.09.014"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2005.040998"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.4712"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2333"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.123.067597","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T13:24:12Z","timestamp":1755523452000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.123.067597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,13]]},"references-count":41,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,2,13]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.123.067597"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.123.067597","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,13]]},"assertion":[{"value":"2023-10-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}