Compliance and Impact of a 5-Min Seated Rest Protocol on Home Blood Pressure Monitoring in Postpartum Women

Abstract

Background: Home blood pressure monitoring (HBPM) is an effective method for diagnosing and managing postpartum hypertension, a condition associated with increased health risks. A 5-min seated rest before home blood pressure (BP) measurement is recommended; however, compliance to this recommendation and its impact on HBPM reading in postpartum women is unknown.

Methods: A subset of participants enrolled in a pregnancy cohort were followed at 3 and 6 months postpartum. At each assessment, participants completed HBPM for seven days with an oscillometric device and concurrently wore an accelerometer on their thigh to assess postures. Mixed-effects models and intraclass correlation coefficients were utilized to analyze BP differences and measurement reliability between 5-min rest compliant and noncompliant readings, respectively.

Results: A total of 45 participants (mean age: 30.5 years) provided HBPM data at 3 and/or 6 months postpartum, with 90.2% of requested BP measures taken. Approximately 33% of readings adhered to the 5-min rest protocol. Compliant readings averaged lower systolic and diastolic BP values than noncompliant readings (SBP: 105.9 mmHg vs. 107.1 mmHg; DBP: 72.6 mmHg vs. 73.2 mmHg), but differences were not clinically relevant. Compliant DBP ICCs fell within the good reliability range (ICCs: 0.785-0.817), while other ICCs indicated moderate reliability.

Conclusions: Despite low compliance with 5 mins of seated rest prior to HBPM, the minimal impact on BP values suggests HBPM remains a useful monitoring strategy in postpartum women, even if the premeasurement rest is not always possible. Future research could evaluate whether shorter premeasurement rest recommendations produce similar findings.

Keywords: accelerometer; blood pressure; blood pressure measurement recommendations; home blood pressure monitoring; hypertension; postpartum.