Rates of high blood pressure during pregnancy doubled between 2008 and 2021, yet only 60% of those affected received treatment, according to a new study published Monday in the journal Hypertension.
“One of the main drivers of adverse outcomes during pregnancy is due to high blood pressure,” said Stephanie Leonard, an Assistant Professor of Obstetrics and Gynecology-Maternal Fetal Medicine at Stanford and lead author of the study.
Chronic hypertension in pregnancy is defined as high blood pressure diagnosed before pregnancy or before 20 weeks of pregnancy. The exact reasons for the dramatic increase in rates are unclear, but prior research suggests that more people are choosing to have children at older ages, which may contribute to the rise.
Serious Complications from Chronic Hypertension
Chronic hypertension can lead to serious complications for both pregnant individuals and their babies. The U.S. maternal death rate is the highest among high-income countries, with Black women experiencing the highest rates and being disproportionately affected by hypertension in pregnancy. “Heart disease is the number one cause of death among women in the U.S., and women have unique risk factors compared to men,” noted Maria Pabon, a cardiologist at Brigham and Women’s Hospital specializing in women’s cardiovascular health.
“High blood pressure during pregnancy can increase the risk of different kinds of heart disease in the future,” Pabon added.
Steps to Lower Risk
Doctors emphasize that there are concrete steps people can take to lower their risk of heart disease, including awareness of the risks associated with a history of high blood pressure during pregnancy. Pabon encourages adopting a heart-healthy diet, such as the Mediterranean diet, and focusing on exercise, sleep, and stress management.
Annual screenings for heart disease should include checking blood pressure, weight, and cholesterol levels. Pabon also recommends that everyone should have a Lipoprotein A level checked at least once. For those with a family history of heart disease, she suggests seeing a cardiologist specializing in women’s health or prevention cardiology.
Home Monitoring and Treatment
Pabon advises asking your doctor if you should monitor your blood pressure at home. If you have a blood pressure monitor, bring it to your next appointment to ensure it fits correctly and provides accurate readings. The American Heart Association offers tips for checking your blood pressure at home:
Don’t smoke, drink caffeinated beverages, or exercise within 30 minutes before taking your blood pressure.
Don’t take measurements over clothes.
Rest for five minutes before checking and sit still.
Check at the same time every day.
Sit up straight with your back supported and feet flat on the floor. Rest your arm on a flat surface.
Take multiple measurements and record the numbers.
Treatment Gaps
According to the new study, only 60% of people with high blood pressure during pregnancy are treated. Typically, medication is prescribed if blood pressure is above 140/90. Dr. Justin Brandt, an Associate Professor in the Department of Obstetrics and Gynecology at NYU Grossman School of Medicine, believes that 60% might be an underestimate due to a lack of awareness among some doctors regarding updated medical guidelines.
In 2022, a major medical group updated its guidance to recommend treating individuals with even mild hypertension during pregnancy, a shift from previous advice which only recommended treatment for blood pressures above 160/110. “Our approach really changed. We realized that treatment reduced complications in pregnancy like pre-eclampsia without affecting fetal growth,” Brandt said.
The findings highlight the need for increased awareness and updated treatment protocols to ensure that more pregnant individuals with high blood pressure receive the necessary care to prevent complications.
