Self-Care Interventions for Preventing Cardiovascular Diseases After Hypertensive Pregnancy Disorders: A Systematic Review and Meta-Analysis.

Abstract

Women with previous hypertensive disorders of pregnancy (HDP) have an increased risk of developing cardiovascular diseases (CVDs) later in life. Self-care interventions are known to promote health and well-being, such as self-measured blood pressure or mindfulness interventions. We evaluated whether self-care interventions reduced the incidence of cardiovascular events, chronic hypertension, and the risk of CVDs in women with previous HDP. MEDLINE, Embase, CINAHL, PsycINFO, and the Cochrane Library were systematically searched on 08 January 2025 without date or language restrictions. Randomised and non-randomised controlled trials. Meta-analysis was performed using random-effects models. We included 16 studies involving 2200 women. Fourteen studies from twelve randomised trials, one was a non-randomised trial, and one was a quasi-experimental study. Data from nine trials involving 952 women with low-certainty evidence showed that self-care interventions may be associated with lower systolic (mean difference from baseline (MD) -3.24; 95% CI -5.42, -1.06 mmHg) and diastolic (MD -3.07; 95% CI -4.88, -1.25 mmHg) blood pressure. Self-care interventions likely decrease the risk of postpartum hypertension readmission (RR 0.35; 95% CI 0.14, 0.89; 3 trials; 605 women; moderate-certainty evidence). There were insufficient studies to pool results for cardiovascular events and chronic hypertension. There was limited evidence to support a recommendation for using self-care interventions to prevent CVDs in women with previous HDP, although some self-care interventions may reduce blood pressure and the risk of postpartum hypertension readmission. Larger trials with multiple and longer follow-ups utilising the core outcome set of CVDs are needed.