Results Summary

What was the research about?

Preeclampsia is a health problem some women have during pregnancy. Symptoms are high blood pressure and a large amount of protein in the urine. Preeclampsia usually goes away after delivery. But women who’ve had preeclampsia have an increased risk of high blood pressure and heart disease later in life.

The research team created a program called Heart Health 4 Moms, or HH4M, to help women who’ve had preeclampsia reduce their risk of high blood pressure and heart disease. The program included

  • Online lessons about diet and healthy lifestyle choices to help prevent heart disease
  • Phone and email access to lifestyle coaching from a dietitian
  • Access to an online forum to talk with the dietitian and others in the program
  • Other resources, such as recipes and an exercise video

To test how well the program worked, the research team compared a group of women who took part in HH4M with a group of women who only had access to a website with educational information.

What were the results?

Compared with women who weren’t in HH4M, nine months after the study began, women in the HH4M group

  • Had more confidence in their ability to change their eating habits
  • Spent less time doing things that aren’t active, like watching television
  • Knew more about risks for heart disease
  • Felt more control over their risk for heart disease

Nine months after the study began, the two groups didn’t differ in how well women followed the recommended eating plan, how much confidence they had in their exercise habits, how much physical activity they took part in, blood pressure, or weight loss.

Who was in the study?

The study included 151 women who had preeclampsia within five years before starting the study. Of these, 82 percent were white, 3 percent were African American, 2 percent were Asian, and 2 percent were multiple races. The average age was 31, and 70 percent were college educated.

What did the research team do?

The research team assigned the women by chance to one of the two groups. The team asked women in the HH4M group to do one online lesson a week for 12 weeks and offered coaching, a forum, and other resources. The other group had access to a website with links to public websites about preeclampsia and heart disease.

At the start of the study, and again nine months later, the women filled out an online survey. The women also submitted their weight and blood pressure using electronic health devices at these same points in time.

Patient advocates who previously had preeclampsia, doctors, people working in social marketing and health care, and representatives from health and prenatal organizations worked with the team during the study.

What were the limits of the study?

Most women in the study were white and had a college degree. Results may differ for women with other backgrounds. In addition, nine months might not be enough time to see changes in weight or blood pressure.

Future research could see if a program like HH4M helps women from diverse backgrounds.

How can people use the results?

Doctors’ offices and others can use these results when considering how best to help women who’ve had preeclampsia avoid future high blood pressure and heart problems.

Final Research Report

View this project's final research report.

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented, and the researchers made changes or provided responses. The comments and responses included the following:

  • Reviewers said that the researchers stated the effects of the Heart Health 4 Moms program on self-efficacy, diet, and physical activity in terms of scales that would be hard for most readers to interpret. The researchers restated the outcomes to better convey the magnitude of the differences observed between the intervention group and the control group.
  • Reviewers expressed concern that the study has limited generalizability because research participants were more highly educated and of higher socioeconomic status than the average population. Also, researchers restricted study participants to women with access to electronic devices and the internet. The researchers agreed that the relatively high socioeconomic status of participants limited the generalizability of the study, and they hope to test their Heart Health 4 Moms program in a higher risk population. But the researchers said Pew Research Center surveys show that the vast majority of women of reproductive age across social strata use smart, electronic devices.
  • Reviewers noted that using an app on a mobile device would be easier than using a website. The researchers said they and the large majority of study participants agreed. The researchers plan to translate the Heart Health 4 Moms program into an app.

Conflict of Interest Disclosures

Project Information

Janet Rich-Edwards, MPH, ScD, and Ellen W. Seely, MD
Brigham and Women's Hospital
Heart Health 4 Moms: Engaging Women with a History of Preeclampsia to Reduce their Risk for Cardiovascular Disease

Key Dates

December 2013
October 2018

Study Registration Information


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Last updated: January 20, 2023