What Are Types Of High Blood Pressure Conditions Before During And After Pregnancy
Your doctor or nurse should look for these conditions before, during, and after pregnancy:1,11
Chronic Hypertension
Chronic hypertension means having high blood pressure* before you get pregnant or before 20 weeks of pregnancy.1 Women who have chronic hypertension can also get preeclampsia in the second or third trimester of pregnancy.1
Gestational Hypertension
This condition happens when you only have high blood pressure* during pregnancy and do not have protein in your urine or other heart or kidney problems. It is typically diagnosed after 20 weeks of pregnancy or close to delivery. Gestational hypertension usually goes away after you give birth. However, some women with gestational hypertension have a higher risk of developing chronic hypertension in the future.1,12
Preeclampsia/Eclampsia
Preeclampsia happens when a woman who previously had normal blood pressure suddenly develops high blood pressure* and protein in her urine or other problems after 20 weeks of pregnancy. Women who have chronic hypertension can also get preeclampsia.
Preeclampsia happens in about 1 in 25 pregnancies in the United States.1,13 Some women with preeclampsia can develop seizures. This is called eclampsia, which is a medical emergency.1,11
Symptoms of preeclampsia include:
Some women have no symptoms of preeclampsia, which is why it is important to visit your health care team regularly, especially during pregnancy.
You are more at risk for preeclampsia if:1
Tips For Counseling Hypertensive Patients On Contraception
This installment of our Complex Contraceptives series examines contraception considerations for patients with high-blood pressure.
Hypertension sequelaeHypertension is a risk factor for CVD, which itself is the top cause of death in the United States.8 Cardiovascular disorders are a top cause of maternal mortality in the United States and hypertensive disorders of pregnancy are specifically responsible for 9.4% of maternal deaths. Patients with a history of preeclampsia have quadruple the risk of developing chronic hypertension.8
Impact on pregnancyAlthough most people with hypertension have no associated complications in pregnancy, hypertension is associated with increased risk for adverse health events as a result of pregnancy. In particular, chronic hypertension is associated with increased risk of gestational diabetes, postpartum hemorrhage, planned cesarean section, and preeclampsia.4 Given the increased risk of preeclampsia, women with chronic hypertension should initiate low-dose aspirin daily prior to 16 weeks gestation for preeclampsia prophylaxis per ACOG and the US Preventive Services Task Force.4,9 Chronic hypertension also carries fetal risks growth restriction, stillbirth, and preterm birth are more common in pregnancies exposed to chronic hypertension.4 Both treated and untreated hypertension are associated with an increase in fetal congenital heart defects .10
CASE
Answer: B
What Does Low Blood Pressure Mean
Some people have naturally low blood pressure . Low blood pressure means that you have a lower risk of heart disease or stroke, but if its too low it can cause health problems.
A low blood pressure reading is a level of 90/60mmHg or lower. If either of the numbers is lower than it should be, this could mean low blood pressure.
Read Also: How Does Apple Cider Vinegar Lower Blood Pressure
Study Selection And Study Characteristics
A total of 6222 articles were retrieved. Five additional articles were found through the reference lists of included articles. After excluding duplicate reports, studies not in humans and not published in English and Chinese, and screening titles and abstracts, we identified 25 potentially relevant records . Three records about the history of hypertension related to the trend of oral contraceptive use, two records for the same study population, one record about menopausal hormone therapy, and two records for prehypertension were further removed. Finally, seventeen published articles including 24 eligible studies with 270 284 participants met the inclusion criteria. Among the included studies, there were one case-control study, four cohort studies, and 19 cross-sectional studies, which were conducted in Oceania, Asia, Europe, and North America. Hypertension was assessed by self-report in 11 studies, and the other 13 studies assessed hypertension by measurement. Eighteen studies were conducted in developed countries, and six studies were conducted in developing countries. The baseline characteristics of the included studies are shown in Table . Study quality was assessed with the Newcastle-Ottawa Scale .
Figure 1
Birth Control For High Blood Pressure
If you decide that you want to stop taking the pill due to high blood pressure, there are other birth control methods that you can safely use:
- Over-the-counter birth control: You can choose any over-the-counter method, including condoms, spermicide, sponge, and female condoms.
- Prescription options: These include an IUD or a diaphragm. Your healthcare provider may also be OK with you using a progestin-only method like Mirena IUD, Skyla IUD, Nexplanon, or Depo Provera.
- Permanent methods: If you know that you are finished having children , you can also safely look into permanent methods like tubal ligation.
Also Check: What Are Symptoms Of Low Blood Pressure
Types Of High Blood Pressure Disorders During And After Pregnancy
If you have high blood pressure before pregnancy, it will need to be managed during and after pregnancy.
In addition, some women who have a healthy blood pressure develop high blood pressure during or after pregnancy.
- Gestational hypertension is blood pressure greater than or equal to 140/90 that develops during pregnancy. Its typically diagnosed after 20 weeks of pregnancy or close to delivery.
- Preeclampsia is a combination of high blood pressure during pregnancy and signs that your organs are not working well, such as high protein levels in your urine. This can lead to life-threatening seizures or coma, a condition known as eclampsia. Women who have had preeclampsia have a higher risk of developing high blood pressure and heart disease later in life.
- HELLP syndrome is a more severe type of preeclampsia or eclampsia.
- High blood pressure disorders may continue after the baby is born. Some women may continue to have high blood pressure problems, including preeclampsia, eclampsia, or HELLP syndrome, after the birth of their child, or their high blood pressure may get worse.
- A sudden spike in blood pressure can also happen during pregnancy or after the baby is born. This is a medical emergency.
Postpartum And Lactating Women
Women remain in a hypercoagulable condition for weeks after childbirth. Product labeling for combination oral contraceptives advises deferring their use until four weeks postpartum in nonbreastfeeding women. Because DMPA and progestin-only contraceptives do not contain estrogen, these methods may be safely initiated immediately after delivery.
The use of combination oral contraceptives in well-nourished breastfeeding women does not result in infant developmental problems, and these drugs may be initiated once milk flow is established. DMPA and progestin-only contraceptives do not impair infant development or lactation and, in fact, may increase the quality and duration of lactation. Because DMPA and progestin-only pills do not have a procoagulation effect and are safe in breastfeeding women, their use at six weeks postpartum in lactating women and immediately after delivery in nonlactating women is reasonable.
Read Also: What To Do If Your Blood Pressure Is Too Low
Your Birth Control Options
There are several types of birth control for people with hypertension. These options include Condoms, the IUD, the shot, the implant, and the mini pill. Condoms and Copper IUDs are free from hormones while the Progesterone IUD, the shot, the implant and the mini pill contain only progesterone. This is especially important, since people with high blood pressure should avoid birth control that contains estrogen. Estrogen can raise blood pressure and may contribute to an increased risk of blood clots and is present in combination with progesterone in many birth control options.
Given the variety of options available to you, consider what best supports your lifestyle and habits. With the mini pill you need to take it at the same time of day to make it most effective. With the Depo Shot, you need to return to your healthcare providers office every three months for an injection. The IUDs and the implant require an insertion visit however, once inserted, they can provide contraception for multiple years depending on the device selected. And, the condom is the only of the listed options that helps protect against STIs and STDs.
Managing High Blood Pressure During Pregnancy
As part of your regular prenatal care, your healthcare provider will measure your blood pressure at each visit. Learn more about how to prepare for a blood pressure test.
If you have high blood pressure, you and your baby will be closely monitored so you can receive special care to lower the chance of complications. You may need to:
- Check your blood pressure at home. Visit Measure Your Blood Pressure for more information.
- Keep track of how many times you feel the baby kicking each day.
- Limit your physical activity. Talk to your healthcare provider about what level of physical activity is right for you.
- Take medicine to control your blood pressure. If you do, talk to your provider about which medicines are safe for your baby. These medicines may include calcium-channel blockers taken by mouth, or beta blockers or vasodilators through an intravenous injection.
- Take aspirin in the second trimester,if you are at risk of preeclampsia and your provider recommends aspirin.
- Visit your provider more often to monitor your condition and your babys growth rate and heart rate. He or she may order blood and urine tests to check how well your organs are working, which can help detect preeclampsia.
Learn about the risks of high blood pressure before, during, and after pregnancy and get questions to ask your doctor.
Don’t Miss: Why Is My Blood Pressure So Low
Are Birth Control Pills And High Blood Pressure Related
Birth control pills or oral contraceptives contain synthetically produced estrogen and progesterone. Some contraceptive pills only have progesterone. Those pills which have both estrogen and progesterone are more prone to cause high blood pressure but only in some women. Other women take contraceptive pills for years and have no problems with these pills. Studies show that estrogen component of the combined pills is mainly responsible for high blood pressure although a few studies conducted by the National Institute of Health have shown that progesterone birth control pills i.e mini pills, are likely to cause a small increase in diastolic pressure so increasing risk of stroke and heart attack in women.
Heading Off High Blood Pressure
The most commonly prescribed oral contraceptives are combination pills, so called because they’re made from a mixture of estrogen and progestin, a synthetic form of progesterone. Because they contain estrogen, these are the ones that have the potential to affect a woman’s blood pressure.
If you’re taking a combination pill and your blood pressure goes up, you have several options depending on whether the increase is significant enough to be concerned about. The most obvious one, if you really like using a pill for birth control, is to try one that contains only progestin. These often are called “mini-pills” and are considered safer for women with high blood pressure. They’re also the smarter choice for those older than 35 who smoke, as well those with a history of blood clots.
Some women find that progestin-only pills are easier to tolerate than combo ones. They’re less likely to cause nausea and headaches that are common side effects of the regular birth control pills. At the same time, they have the disadvantage of causing some bleeding between periods for the first several months a woman takes them. And timing is more important with progestin-only pills: They must be taken at the same time each day.
Don’t Miss: What Is Diastolic Blood Pressure
What Are The Different Types Of Birth Control
Women can choose from many different types of birth control methods. These include, in order of most effective to least effective at preventing pregnancy:
- Female and male sterilization Birth control that prevents pregnancy for the rest of your life through surgery or a medical procedure.
- Long-acting reversible contraceptives or “LARC” methods Birth control your doctor inserts one time and you do not have to remember to use birth control every day or month. LARCs last for 3 to 10 years, depending on the method.
- Short-acting hormonal methods Birth control your doctor prescribes that you remember to take every day or month. The shot requires you to get a shot from your doctor every 3 months.
- Barrier methods Birth control you use each time you have sex.
- Natural rhythm methods Not using a type of birth control but instead avoiding sex and/or using birth control only on the days when you are most fertile . An ovulation home test kit or a fertility monitor can help you find your most fertile days.
Does Birth Control Affect Your Blood Pressure
For the most part, birth control pills are safe.
Most women who use birth control experience either no side effects, or minor side effects like nausea, breast tenderness, headaches and dizziness that usually disappear after two to three months.
However, some forms of birth control can cause an increase in blood pressure. These include most birth control pills, patches, rings and other forms of birth control that use hormones such as estrogen.
According to a 2012 study, about eight percent of all women of reproductive age and more than 18 percent of women specifically aged 40 to 44 have hypertension, making this a fairly common problem.
Also Check: How Do You Raise Low Blood Pressure
What Do I Do If I Miss A Day Taking The Pill
Follow the instructions that came with your birth control about using back-up birth control . You also can follow these recommendations from the Centers for Disease Control and Prevention.1
If you are late or miss a day taking your pill:
- Take the late or missed pill as soon as possible.
- Continue taking the rest of your pills at your normal time, even if it means taking two pills on the same day.
- You do not need other forms of birth control, such as a condom, unless you need to protect against STIs.
If you miss two or more days in a row:
- Take only the most recent missed pill as soon as possible.
- Continue taking the rest of your pills at your normal time, even if it means taking two pills on the same day.
- Use back-up birth control, such as a condom and spermicide, or do not have sex until you have taken a pill for seven days in a row.
- If you missed pills during days in the last week of active pills , start a new pack the next day. If you are not able to start a new pack right away, use back-up birth control or avoid sex until hormone pills from a new pack have been taken for 7 days in a row.
- Consider emergency contraception if you missed pills during the first week and had sex.
Talk to your doctor if you continue to miss taking your birth control pill or find it hard to take the pill at the same time each day. You may want to consider a different type of birth control, such as an IUD, an implant, shot, ring, or patch that you don’t have to remember to take every day.
High Blood Pressure Risk Factors
The risk of high blood pressure increases with your age. When women stop taking the pill, their blood pressure usually becomes lower. But some research says that birth control pills may cause a small increase in diastolic pressureand this can continue in older women who have been off the pill for years.
The actual risk of developing high blood pressure while using birth control pills is not known. It is thought that the estrogen in the pill may trigger the release of other hormones that can cause your blood pressure to rise. Progestin has also been found to affect blood pressurebut it does not seem to increase blood pressure to the same degree that estrogen does.
There are some risk factors that may also make it more likely that birth control pill use will increase your blood pressure. These risk factors include:
- A history of high blood pressure when you were pregnant
- A family history of high blood pressure
- A history of heart problems or blood vessel issues
Also Check: What Are The Symptoms Of Fluctuating Blood Pressure
Birth Control And Blood Pressure
Doctors and researchers have found a link between birth control pills and an increase in blood pressure among some women. They say that it is more likely to occur in women who are already overweight, have kidney disease or have a family history of high blood pressure.
Note: A combination of birth control pills and smoking can be very dangerous to women and is not recommended. Especially in younger women, the combination of birth control pills and smoking increases the risk of heart disease by a whopping 20 percent.
Worried about your blood pressure and how it relates to birth control usage? Consult your doctor before starting any medications and have your blood pressure levels checked every six months to make sure you are in a healthy range.
Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.
Is It True That Women Are More Likely To Get Hypertension
There are some health conditions that impact one gender more than the other, but when it comes to hypertension or high blood pressure, the lines arent clear cut. Men and women are both susceptible to elevated blood pressure and the complications it triggers, and neither sex is necessarily more vulnerable than the other. In fact, according to the Centers for Disease Control and Prevention , men and women suffer from hypertension almost equally: 47% of men vs. 43% of women.
There are, however, factors unique to women that can put them at higher risk during different phases and stages of their lives. Dr. Bhavani Jeereddy at Kenilworth Primary Care encourages all her patients to have their blood pressure checked regularly, as hypertension is often asymptomatic. But if you’re a woman, pay careful attention if you can relate to any of the following scenarios.
Don’t Miss: How Much Does Anxiety Raise Blood Pressure