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Lifestyle Outcomes Six and Twelve Months After Hypertensive Disorders of Pregnancy: A Blood Pressure Postpartum
Jenny Zhang1, Lynne Roberts2,3, Kaylee Slater4
1Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, Sydney, NSW 2031, Australia.
Insights
Intensive lifestyle interventions improved vegetable intake and nutrition awareness in women post-hypertensive disorders of pregnancy (HDP) at 12 months. These changes show promise for long-term cardiovascular disease risk reduction.
Area of Science:
- Cardiovascular Health
- Obstetrics
- Public Health
Background:
- Hypertensive disorders of pregnancy (HDP) significantly elevate the risk of future cardiovascular disease (CVD).
- Limited research exists on lifestyle interventions to mitigate post-HDP cardiovascular risk.
- This study evaluates dietary and physical activity changes following HDP in response to different lifestyle interventions.
Purpose of the Study:
- To compare the 6-month and 12-month dietary and physical activity outcomes of women post-HDP.
- To assess the effectiveness of three distinct lifestyle interventions on health behaviors.
- To identify correlations between lifestyle factors and cardiometabolic markers post-HDP.
Main Methods:
- A sub-study of the Blood Pressure Postpartum (BP²) randomised controlled trial involving 405 women across six Sydney hospitals.
- Participants were assigned to usual care, brief education with counseling, or extended lifestyle intervention with telephone coaching.
- Diet and physical activity were assessed using the NSW Population Health Survey; cardiometabolic measures were also collected at 6 and 12 months.
Main Results:
- The extended lifestyle group significantly increased daily vegetable intake from 6 to 12 months (2.0 to 3.0 serves/day, p=0.001).
- No significant changes in fruit intake or physical activity were observed across groups.
- Increased vegetable and fruit intake correlated with lower BMI and waist circumference; increased vigorous exercise correlated with lower BMI and waist circumference.
Conclusions:
- Intensive lifestyle interventions, particularly extended programs, can improve vegetable consumption and nutrition awareness in women post-HDP.
- These improvements suggest potential long-term benefits for cardiovascular health and reduced cardiometabolic risk.
- Further research is warranted to confirm sustained effects and broader cardiometabolic impacts.
Abstract:
Background/Objectives: Hypertensive disorders of pregnancy (HDP) increase the risk of cardiovascular disease (CVD), but few studies have explored the efficacy of lifestyle interventions to improve CVD risk post-HDP. This study compared the 6 month (6M) and 12 month (12M) dietary and physical activity outcomes of women post-HDP participating in one of three lifestyle interventions. Methods: This sub-study of the Blood Pressure Postpartum (BP2) randomised controlled trial included participants from six hospitals across Sydney, Australia, randomly assigned to one of three groups: Group 1 (usual care) received general postpartum health information; Group 2 (brief education) received usual care plus an individualised cardiovascular risk assessment and lifestyle counselling; Group 3 (extended lifestyle) received all Group 2 components plus enrolment in a six-month telephone coaching programme. Baseline and post-intervention data were collected at 6M and 12M, respectively. Diet and physical activity were assessed using the NSW Population Health Survey, alongside cardiometabolic measures. Results: Overall, 405 women provided complete 6M and 12M data (Group 1 n = 129, Group 2 n = 137, Group 3 n = 139). From 6M to 12M, Group 3 increased their vegetable serves/day (3.0 vs. 2.0, p = 0.001). No significant changes in fruit intake and physical activity levels were observed among groups. Groups 2 and 3 reported that nutritional information had a greater influence on their food choices at 12M (p = 0.010 and p < 0.001, respectively). At 12M, higher vegetable and fruit intake correlated with lower body mass index (BMI) (p = 0.006, p = 0.003) and waist circumference (p = 0.035, p = 0.014), and increased vigorous and strength exercise correlated with lower BMI (p = 0.005, p = 0.003) and waist circumference (p < 0.001, p < 0.001). Conclusions: Intensive lifestyle interventions improved vegetable intake and nutrition awareness in post-HDP women at 12M, holding promise for long-term cardiometabolic health benefits.
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