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J Womens Health (Larchmt). 2019 Jun 19. doi: 10.1089/jwh.2018.7523. [Epub ahead of print]

Randomized Trial to Reduce Cardiovascular Risk in Women with Recent Preeclampsia.

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1 Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
2 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
3 Preeclampsia Foundation, Melbourne, Florida.
4 Laboratory for Psychiatric Biostatistics, McLean Hospital, Belmont, Massachusetts.
5 Harvard Medical School, Boston, Massachusetts.
6 Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
7 Department of Obstetrics, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
8 College of Social Work, University of South Carolina, Columbia, South Carolina.


Background: To reduce cardiovascular disease (CVD) risk, we tested an online intervention to improve healthy lifestyle for women with recent preeclampsia. Methods: We conducted a randomized controlled 9-month clinical trial, Heart Health 4 Moms (HH4M), among 151 U.S. women with preeclampsia within 5 years. Sample size was planned to detect differences of 0.5 standard deviation units in primary outcomes between study arms. Preeclampsia history was validated by medical records; women with chronic hypertension were excluded. The intervention included online educational modules, a community forum, and communication with a lifestyle coach. The control group received internet links to CVD risk reduction information. Primary outcomes were self-efficacy to eat a healthy diet and increase physical activity; change in physical in/activity; adherence to the Dietary Approaches to Stop Hypertension (DASH) diet; and knowledge of and personal control over CVD risk. Secondary outcomes were weight and blood pressure. Results: In the intervention arm, 84% of participants accessed at least one online educational module; 89% completed at least three scheduled calls with the coach. At 9 months, intervention participants reported significantly greater knowledge of CVD risk factors (corrected p = 0.01), increased self-efficacy for healthy eating (p = 0.03), and less physical inactivity than controls (p = 0.0006). The groups did not differ in sense of personal control of CVD risk factors, adherence to the DASH diet, self-efficacy for physical activity, or reported physical activity. There were no differences in secondary outcomes between groups. Conclusions: The HH4M program improved CVD risk knowledge, self-efficacy to achieve a healthy diet, and reduced physical inactivity among women with recent preeclampsia.


cardiovascular health; hypertension; intervention; preeclampsia; pregnancy; randomized controlled trial; women's health


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