# Blood Pressure Measurement and Hypertension in Pregnancy

> **NIH NIH K23** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2021 · $192,893

## Abstract

PROJECT SUMMARY/ABSTRACT
Dr. Natalie A. Bello is a cardiologist whose long-term career goal is to generate and disseminate empiric
evidence to reduce the burden of maternal-fetal morbidity and mortality resulting from hypertensive disorders
of pregnancy (HDP). She seeks a K23 Career Development Award to attain this goal, and has assembled a
multidisciplinary team of senior investigators in hypertension (HTN) (Drs. Daichi Shimbo and Suzanne Oparil),
out-of-clinic blood pressure (BP) measurement including home BP monitoring (HBPM) (Drs. Shimbo and
Joseph Schwartz), epidemiology (Dr. Paul Muntner), maternal-fetal medicine (Drs. Alan Tita and Ronald
Wapner), and biostatistics (Drs. Schwartz and Muntner). Dr. Bello’s training will consist of four modules: (1)
Hypertensive Disorders of Pregnancy, (2) Research Aspects of the Diagnosis and Treatment of HTN, (3)
Advanced Study Design and Statistical Analysis in HTN, and (4) Research Dissemination and Transition to
Independence. HDP, including chronic and gestational HTN, are associated with substantial maternal-fetal
morbidity and mortality. The accurate determination of BP in pregnant women with chronic and gestational
HTN is essential, as both under- and over-treatment of HTN may result in harm to the mother and/or fetus.
Traditional clinic BP (CBP), which involves a healthcare provider measuring BP, is a poor surrogate for
ecological BP in the naturalistic environment. Compared to CBP, out-of-clinic BP on HBPM better estimates
ecological BP, and thus may be a superior measure of placental perfusion. Although these data suggest that
HBPM has an essential role in the management of chronic and gestational HTN, there are several knowledge
gaps that limit the widespread use of HBPM in this population. The minimum number of days of HBPM to
reliably estimate mean home BP, and the long-term adherence to HBPM during pregnancy among women with
chronic and gestational HTN are unknown. Finally, studies of non-pregnant individuals show that compared to
traditional CBP, CBP measured using an automated device in the absence of a healthcare provider
(unattended CBP) may better approximate out-of-clinic BP. In the proposed project, the minimum number of
days of HBPM needed to provide a reliable estimate of mean home BP (Primary Aim 1) and the long-term
adherence to HBPM during pregnancy (Primary Aim 2) will be determined. Whether mean unattended CBP
versus traditional CBP is closer to mean home BP (Secondary Aim) will also be assessed. Primary Aim 1 and
Secondary Aim will be addressed among 105 pregnant women (<34 weeks gestation) with chronic and
gestational HTN who will undergo HBPM for 14 days with traditional and unattended CBP measurement (Study
1). Primary Aim 2 will be addressed among 75 pregnant women with chronic and gestational HTN who will
undergo HBPM daily from the second trimester (gestational week 20-26) through delivery (Study 2). These
data will inform Dr. Bello’s program of research on HDP, and will p...

## Key facts

- **NIH application ID:** 10137299
- **Project number:** 5K23HL136853-04
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Natalie A Bello
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $192,893
- **Award type:** 5
- **Project period:** 2018-04-01 → 2021-09-03

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10137299

## Citation

> US National Institutes of Health, RePORTER application 10137299, Blood Pressure Measurement and Hypertension in Pregnancy (5K23HL136853-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10137299. Licensed CC0.

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