None listed
Conditions
Brief summary
A diagnosis of pre-eclampsia or gestational hypertension have long-term implications for women's health, with an associated increase in lifetime risk of ischaemic heart disease, stroke, and heart failure. Research suggests earlier cardiovascular risk assessment for women with a history of hypertensive pregnancy disorders would likely benefit from establishing care with a cardiologist before the age of 45 to optimise modifiable risk factors and initiate primary prevention strategies to reduce cardiovascular disease. Behavioural science studies have also shown that positive behavioural changes are more likely when individuals are already undergoing significant life changes. This study aims to review if early intervention of diet and lifestyle counselling and cardiovascular assessment. help improve cardiovascular outcomes in women post delivery of their baby. Through two post natal cardiovascular follow up visits one at 3 months and one at 9 months post delivery and if necessary a review with a cardiologist.
Interventions
Two one-hour face to face participant education and health counselling sessions will be provided by the Cardiovascular nurse/research nurse to include: Diet and exercise to optimise cardiovascular risk factors in women who have been diagnosed with pre-eclampsia and gestational hypertension during pregnancy.
Use of educational materials from The Australian heart foundation on management of hypertension and cholesterol. Health eating diet literature/heart smart.
Review of Cardiovascular risk facto
Two one-hour face to face participant education and health counselling sessions will be provided by the Cardiovascular nurse/research nurse to include: Diet and exercise to optimise cardiovascular risk factors in women who have been diagnosed with pre-eclampsia and gestational hypertension during pregnancy. Use of educational materials from The Australian heart foundation on management of hypertension and cholesterol. Health eating diet literature/heart smart. Review of Cardiovascular risk factors including blood pressure and Cholesterol levels and treating as per current best practice. The sessions are face to face one on one sessions in the obstetric outpatients dept. The first session is at Visit 1 which is 3 months post-delivery. The second session at visit 2 is 9 months later when the baby is 12 months old. Topics to be covered include diet review. Using a MEDAS questionnaire. Looking at quantities of red & white meat consumption, Nuts, tomatoes, olive oil. fruits and vegetables, sweetened beverages, pulses and fish, and fast food on a daily and weekly basis. Weight review, BMI salt intake and processed foods will also be reviewed aiming for long tern weight control. Two visits over a nine-month period as required one 3 months post-delivery of the baby and 9 months later. Activity and gentle exercise including moderate and vigorous will be discussed. Advice will be provided on the importance of keeping active. Aiming for participates to be a active as possible. Aiming for 150 minutes of moderate activity weekly which can be incorporated into their daily routine for example brisk walking- pushing the pram/buggy as well as home exercises. Pilates, dancing and cycling. The cardiovascular nurse specialist will provide support through the study via email, zoom and phone contact on an individual basis. Providing encouragement throughout the study and to try and maintain adherence. The outcomes will be self-reported by participants.
Sponsors
Epworth medical foundation
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Educational / counselling / training
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Women over the age of 18 years with a recent pregnancy with a diagnosis of • Gestational hypertension defined as new-onset hypertension in pregnancy (systolic blood pressure of 140mmHg or above and/or diastolic of 90mmHg or above • Pre-eclampsia defined as new-onset hypertension in pregnancy (systolic blood pressure of 140mmHg or above and/or diastolic more than or equal to 90mmHg or with proteinuria, other specific end-organ dysfunction, or uteroplacental dysfunction, after 20 weeks of gestation.
Exclusion criteria
• Pregnant women • Women under the age of 18 years at delivery • Women with any unstable medical conditions defined as any condition that changes frequently or rapidly or requires constant monitoring or frequent treatment regimens or conditions resulting in limited life expectancy. Or any medical condition that would preclude diet and exercise participation. Such as, any pre-existing cardiac disease with an abnormal cardiac function on Echocardiogram, Left ventricular failure (LVF) Congested cardiac failure (CCF). • Insulin dependent diabetic (IDDM)with poor glycemic control, and recurrent episodes of hypoglycemia. • Renal transplant patients, on multiple immunosuppressive medications. • Chronic lung disease with impaired exercise tolerance. • Women with cognitive impairment or who are unable to provide consent
Outcome results
None listed