# Lifestyle Outcomes Six and Twelve Months After Hypertensive Disorders of Pregnancy: A Blood Pressure Postpartum Sub-Study

## TL;DR

This study examined how different lifestyle interventions affected diet and physical activity in women after pregnancy-related high blood pressure, finding that an extended program improved vegetable intake and nutrition awareness.

## Contribution

The study introduces a novel comparison of three lifestyle interventions for post-HDP women, focusing on long-term dietary and physical activity outcomes.

## Key findings

- Group 3 increased vegetable intake significantly from 6 to 12 months.
- Higher vegetable and fruit intake correlated with lower BMI and waist circumference at 12 months.
- Increased vigorous and strength exercise correlated with lower BMI and waist circumference at 12 months.

## Abstract

Background/Objectives: Hypertensive disorders of pregnancy (HDP) increase the risk of cardiovascular disease (CVD), but few studies have explored the efficacy of lifestyle interventions to improve CVD risk post-HDP. This study compared the 6 month (6M) and 12 month (12M) dietary and physical activity outcomes of women post-HDP participating in one of three lifestyle interventions. Methods: This sub-study of the Blood Pressure Postpartum (BP2) randomised controlled trial included participants from six hospitals across Sydney, Australia, randomly assigned to one of three groups: Group 1 (usual care) received general postpartum health information; Group 2 (brief education) received usual care plus an individualised cardiovascular risk assessment and lifestyle counselling; Group 3 (extended lifestyle) received all Group 2 components plus enrolment in a six-month telephone coaching programme. Baseline and post-intervention data were collected at 6M and 12M, respectively. Diet and physical activity were assessed using the NSW Population Health Survey, alongside cardiometabolic measures. Results: Overall, 405 women provided complete 6M and 12M data (Group 1 n = 129, Group 2 n = 137, Group 3 n = 139). From 6M to 12M, Group 3 increased their vegetable serves/day (3.0 vs. 2.0, p = 0.001). No significant changes in fruit intake and physical activity levels were observed among groups. Groups 2 and 3 reported that nutritional information had a greater influence on their food choices at 12M (p = 0.010 and p < 0.001, respectively). At 12M, higher vegetable and fruit intake correlated with lower body mass index (BMI) (p = 0.006, p = 0.003) and waist circumference (p = 0.035, p = 0.014), and increased vigorous and strength exercise correlated with lower BMI (p = 0.005, p = 0.003) and waist circumference (p < 0.001, p < 0.001). Conclusions: Intensive lifestyle interventions improved vegetable intake and nutrition awareness in post-HDP women at 12M, holding promise for long-term cardiometabolic health benefits.