Postpartum Home Visiting (HEART at Home)

The goal of this clinical trial is to learn whether HEART at Home (Home-based Engagement And Remote Treatment for Hypertension), a home-based postpartum hypertension care program, is feasible and acceptable for people with high blood pressure after delivery and the health care teams caring for them. The main questions it aims to answer are: Is HEART at Home feasible to deliver, including successful enrollment, completion of home visits and blood pressure monitoring, and delivery of the planned intervention? Is HEART at Home acceptable to participants and health care providers? The study will also explore changes in blood pressure control and track emergency room visits and hospital readmissions related to high blood pressure. Participants will: Measure their blood pressure at home using a provided blood pressure cuff and securely share their readings with the health care team. Receive home visits and phone or text check-ins from trained postpartum doulas for the first three months after delivery. Doulas will provide education, assist with blood pressure monitoring, and help participants connect with ongoing medical care. Have their blood pressure readings reviewed by nurses and doctors, who may adjust blood pressure medications as needed. At 12 weeks after delivery, a plan set for ongoing care with a primary care provider or heart specialist.

Inclusion Criteria: * • Age ≥18 years * Enrollment in the Barnes Jewish Hospital rBPM program; as per eligibility criteria above, patient has a physician-made diagnosis of HDP per American College of Obstetricians and gynecologists criteria * Measured at least 4 days of blood pressure during initial program * At least one blood pressure was made after monitoring day 7 * Confirmed at least two separate blood pressure ≥130/80 mm Hg at the end of the 14-day rBPM period * Ability and willingness to participate in home visits and remote monitoring * Able to communicate in English or Spanish without the need for interpretation services Exclusion Criteria: * • Inability to provide informed consent * Physician determination of inability to measure blood pressure at home due to comorbidities or other limiting conditions * No access to a phone