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

Abstract

Background: 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. Objectives: We evaluated whether self-care interventions reduced the incidence of cardiovascular events, chronic hypertension, and the risk of CVDs in women with previous HDP. Search Strategy: MEDLINE, Embase, CINAHL, PsycINFO, and the Cochrane Library were systematically searched on 08 January 2025 without date or language restrictions. Selection Criteria: Randomised and non-randomised controlled trials. Data Collection and Analysis: Meta-analysis was performed using random-effects models. Main Results: 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. Conclusions: 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.