High Blood Pressure

Chronic hypertension, Gestational hypertension and Pre-eclampsia

​

• Hypertensive disorders of pregnancy are one to leading causes of maternal and perinatal death worldwide. 

• What is chronic hypertension?  Having high blood pressure as a pre-existing condition, prior to pregnancy

• What is gestational hypertension? Having a systolic BP > 140 or Diastolic BP >90 on two occasions at least 4 hours apart after 20 weeks during pregnancy

• What is pre-eclampsia?  Pre-eclamspia is a pregnancy condition that is associated with new onset high blood pressure, after 20 weeks gestation (or frequently, near term) that meets criteria for gestational hypertension, but also usually causes protein in urine and has the potential to affect other organs including the kidney, liver, etc.  

• It's estimated that pre-eclampsia complicates 2-8% of pregnancies

• Risk factors for pre-eclampsia include: first pregnancy, twin or multi-fetal pregnancy, having pre-eclampsia in a prior pregnancy, chronic hypertension, diabetes (prior to and during pregnancy), thrombophilia (a condition that increases risk for blood clots), lupus, obesity, sleep apnea, maternal age 35 or greater, kidney disease, assisted reproduction to achieve pregnancy

​

Can anything be done to prevent pre-eclampsia in pregnancy?

• Although this question has been studied for more than 30 years, there has yet to be found a definitive way of preventing pre-eclamspia in pregnancy

• In terms of nutritional interventions, there is insufficient evidence to demonstrate effectiveness of vitamins C, D, or E, fish oil, garlic, folic acid, or sodium restriction in decreasing risk of pre-eclampsia.  

• Recently, baby aspirin supplementation, especially in women at risk of having pre-eclampsia has shown some promise