Struggling With High Blood Pressure
Are you one of many asking themselves and searching for answers to the following questions? How to lower blood pressure in minutes?, how to lower diastolic blood pressure fast? or tricks to lower blood pressure instantly? Then keep reading because Trogolo OBGYN shares all these tips and tricks to keep you and your high blood pressure in check.
Risk Of Bias In Included Studies
Most of the included trials were small. Only five studies recruited more than 100 women which recruited 124 women, 126 women, 1750 women, 150 and 200 women. As discussed above, a wide variety of agents were compared. Several trials were conducted in countries where English is not widely used, and it is possible that the search strategy may have missed other studies published in languages other than English.
See for summaries of ‘Risk of bias’ assessments in included trials.
‘Risk of bias’ summary: review authors’ judgements about each risk of bias item for each included study.
Sixteen trials had adequate methods for random sequence generation and 13 trials had adequate concealment of allocation. Most of the others did not give adequate information about how or whether the allocation to treatment group was concealed.
For most trials the identity of the allocated drug could only be blinded after trial entry with use of a double placebo. This was stated to have been done in only two studies . In another four, the comparison was stated to have been blinded . It was clearly stated in some trials that they were either “open” or not blinded .
In three trials, blinding of some outcome assessment was performed . In one trial, it was reported that it was not blinded, but that the primary outcome of eclampsia is a binary, objective outcome and therefore not subject to observer or measurement bias .
Incomplete outcome data
Will My Pregnancy Be Classified As High
One indicator of a high-risk pregnancy includes certain chronic medical problems, such as high blood pressure. Therefore, since you already have hypertension and have become pregnant, your pregnancy is automatically classified as high risk.
High-risk pregnancies typically need expert advice and the care of a healthcare specialist. You will most likely see a perinatologist- an obstetrician who specializes in the care of high-risk pregnancies. Perinatologists give expert care to women who have pre-existing medical conditions, as well as women who develop complications during pregnancy.
In addition, you may be referred to a perinatal care center, before delivery, to lessen the likelihood your baby may become ill. Usually, these centers work together with obstetricians and a newborn intensive care unit to provide the best care for you and your baby.
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Severe Hypertension Or If Pre
If your blood pressure becomes severely high or you develop pre-eclampsia, you may be referred to an obstetrician or a specialist for treatment or monitoring and may need admission to hospital. You will need much closer supervision and will probably need to have your baby early.
The treatment and monitoring aim to keep you and your baby safe while your baby grows and develops as much as possible. If your baby does need to be delivered early there are treatments available to decrease the complications of being born prematurely.Read more about pre-eclampsia.
Description Of The Intervention
Once blood pressure reaches 170 mmHg systolic or 110 mmHg diastolic, the woman is at increased risk of harmful effects. There is therefore a general consensus that she should receive antihypertensive drugs, to lower her blood pressure, and that she should be in a hospital. The aim of treatment is to quickly bring about a smooth reduction in blood pressure to levels that are safe for both mother and baby, but avoiding any sudden drops that may in themselves cause problems such as dizziness or fetal distress.
A wide range of antihypertensive drugs have been compared for management of severe hypertension during pregnancy. The most commonly recommended drugs include hydralazine, labetalol and nifedipine and there is most experience with these.
In general, maternal sideeffects are not different from those in the nonpregnant state, and are listed in pharmacological texts. All drugs used to treat hypertension in pregnancy cross the placenta, and so may affect the fetus directly by means of their action within the fetal circulation, or indirectly by their effect on uteroplacental perfusion.
Treating High Blood Pressure In Pregnancy
Is treatment necessary?
Your healthcare provider wont always recommend medications for high blood pressure during pregnancy.
The American College of Obstetricians and Gynecologists recommends that pregnant women with severe high blood pressure take medication to lower their blood pressure. Severe high blood pressure is when the systolic blood pressure is 160 or higher and/or the diastolic BP is 110 or higher. Between 140-159 systolic, and 90-109 diastolic, the science is less clear. If you have symptoms like headache and blurred vision you might need treatment.
Are blood pressure medications safe during pregnancy?
This is the million dollar question. All blood pressure-lowering medications cross the placenta and get into your babys bloodstream. But, not treating high blood pressure in pregnancy can have harmful results for mom and baby.
The concern with treating high blood pressure in pregnancy is that lowering blood pressure too quickly, and the medications themselves, can cause low birth weight. But large studies have not shown consistently whether or not this is a real concern.
Healthcare professionals are also not sure whether treating high blood pressure in pregnancy actually lowers risk of birth complications, stroke, or preeclampsia. The results of the 2018 Cochrane review and the 2017 meta-analysis show that treating high blood pressure in pregnancy lowers the risk of severe high blood pressure, but does not lower the risk of birth complications or preeclampsia.
Can A Woman With High Blood Pressure Get Toxemia
Women who have previously had pregnancy-induced hypertension are more likely to develop toxemia. It is always difficult for an expectant mother to find that the presence of toxicosis is making her pregnancy more difficult. However, constant worry and heightened anxiety can only make the situation worse.
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Monitor Your Salt Intake
Generally, when people with high blood pressure cut back on salt, their blood pressure falls. It even prevents blood pressure from rising.
A 2014 study published in Electrolytes & Blood Pressure shows that a reduction of dietary salt intake can decrease the number of deaths from hypertension, cardiovascular disease, and strokes.
A 2016 study by McMaster University found that, low-salt diets may actually increase the risk of cardiovascular disease and death compared with average salt consumption. The research suggests that the only people who need to worry about reducing sodium in their diet are those with hypertension who have high salt consumption.
Always remember that the body needs a small amount of sodium to work properly, but excess salt will only increase your blood pressure and your risk for heart disease or stroke.
During pregnancy, you must keep a check on your salt intake to keep your blood pressure under control.
- Do not add a lot of salt to foods. Use herbs and spices instead to add flavor to your dish.
- Avoid processed foods, fast food, and sports drinks, which are high in sodium even if they dont taste salty.
- Avoid canned foods as they are often high in sodium.
What Are The Symptoms Of Preeclampsia
Possible symptoms of preeclampsia include:
- High blood pressure
- Too much protein in your urine
- Swelling in your face and hands. Your feet may also swell, but many women have swollen feet during pregnancy. So swollen feet by themselves may not be a sign of a problem.
- Headache that does not go away
- Vision problems, including blurred vision or seeing spots
- Pain in your upper right abdomen
- Trouble breathing
Eclampsia can also cause seizures, nausea and/or vomiting, and low urine output. If you go on to develop HELLP syndrome, you may also have bleeding or bruising easily, extreme fatigue, and liver failure.
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Eating A Healthy Diet
High Blood Pressure In Pregnancy
High blood pressure in pregnancy is a common medical problem that usually disappears once the baby is born. In some cases, it can signal a serious condition called pre-eclampsia.
Your blood pressure is a measure of how strongly your blood pushes against the walls of the blood vessels. Its normally recorded in 2 numbers: the top one is the pressure when the heart is pumping, and the bottom one is the pressure in between each beat.
When you are pregnant, you are considered to have high blood pressure when the top number is 140 or more or the bottom number is 90 or more . High blood pressure is sometimes called hypertension.
Seek medical attention urgently if you have high blood pressure in pregnancy along with:
- a severe headache
- sudden swelling of the face, hands and feet
- a pain in your upper abdomen
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Classification Of Hypertension In Pregnancy And Treatment Guidelines
According to NHBPEP and The American College of Obstetricians and Gynecologists practice bulletins, hypertension in pregnancy is classified as chronic hypertension, preeclampsia-eclampsia, preeclampsia superimposed upon chronic hypertension and gestational hypertension . Chronic hypertension is defined as BP 140/90mm Hg before pregnancy or < 20th week of gestation or use of antihypertensive medication before pregnancy. Preeclampsia-eclampsia is a pregnancy-specific disorder that occurs after 20 weeks gestation. Eclampsia is the convulsive form of preeclampsia and affects 0.1% of all pregnancies. Preeclampsia can also occur superimposed upon chronic hypertension. Gestational hypertension is defined as new onset BP 140 mmHg systolic or 90 mmHg diastolic on at least two occasions, at least 6 h apart, after 20 weeks gestation, in the absence of proteinuria. This category encompasses women with preeclampsia who have not yet developed proteinuria, those with transient hypertension, if BP returns to normal by 12 weeks postpartum, and women with chronic hypertension, if BP elevation persists after 12 weeks.
The NHBPEP guidelines state that in pregnancy normal or acceptable blood pressure is SBP140 and DBP90 mmHg, mild hypertension SBP 140 to 150 or DBP 90 to 109 mmHg and severe hypertension 160 systolic or 110 diastolic mmHg.
How To Deal With Low Blood Pressure During Pregnancy
Pregnant women will experience dizziness due to low blood pressure however, you can try these simple steps to minimize the symptoms as well as promote safety.
- Try to lie on your left side as it increases the flow of blood to your heart
- Avoid some sudden movement particularly when standing up from a seated position
- Avoid standing for long durations of time
- Wear support stockings, usually compression stockings
- Avoid caffeinated drinks or beverages and alcohol
- Consume several small meals during the day instead of the normal three large meals
- Exercise regularly because it sharpens the reflexes and helps keep the blood pressure within the normal range. Consult with your physician regarding the exercises you can do while pregnant.
- Drink plenty of fluids a pregnant woman should drink more water than the recommended amount for normal people, usually drink between three quarts and a gallon of water a day.
When to Call the Doctor
In case the condition gets out of hand, you can always seek for professional help from your medical health care provider. Dizziness may be associated with troubling symptoms which should be observed keenly. It is recommended that any pregnant woman access emergency care in case she starts fainting, or starts experiencing more serious symptoms i.e. severe headache, blurring, weakness or numbness on one side of the body and shortness of breath.
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What Steps Can I Take To Have A Safe Delivery With High Blood Pressure During Pregnancy
Steps that patients with high blood pressure during pregnancy can take to help the chances of having a safe and healthy delivery include:
- Taking any blood pressure medication as prescribed
- Going to all of your prenatal visits
- Having an early delivery if it is needed
- Maintaining a healthy diet
- Following your healthcare providers instructions regarding activity and exercise
Antihypertensive Medications That Are Not Safe During Pregnancy
Some medicines used to treat high blood pressure should not be taken during pregnancy as they may harm a developing baby.
Examples of blood pressure medicines that should not be taken during pregnancy are:
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If You Are Already Taking Medicine For High Blood Pressure
If you’re already taking medicine to lower your blood pressure and want to try for a baby, talk to your GP or specialist first. They may want to switch you to a different medicine before you get pregnant.
If you find out you’re already pregnant, tell your doctor immediately. They may need to change your medicine as soon as possible.
This is because some medicines that treat high blood pressure may not be safe to take when you’re pregnant. They can reduce the blood flow to the placenta and your baby, or affect your baby in other ways.
What Pregnancy Complications Can High Blood Pressure Cause
High blood pressure can cause problems for you and your baby during pregnancy, including:
Problems for moms include:
If you have high blood pressure during pregnancy, youre also more likely have a cesarean birth . This is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.
Problems for babies include:
- Premature birth. This is birth that happens too early, before 37 weeks of pregnancy. Even with treatment, a pregnant woman with severe high blood pressure or preeclampsia may need to give birth early to avoid serious health problems for her and her baby.
- Fetal growth restriction. High blood pressure can narrow blood vessels in the umbilical cord. This is the cord that connects the baby to the placenta. It carries food and oxygen from the placenta to the baby. If you have high blood pressure, your baby may not get enough oxygen and nutrients, causing him to grow slowly.
- Low birthweight. This is when a baby is born weighing less than 5 pounds, 8 ounces.
- Fetal death. When a baby dies spontaneously in the womb at any time during pregnancy.
- Neonatal death. This is when a baby dies in the first 28 days of life.
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What Is High Blood Pressure
Blood pressure is the force of blood that pushes against the walls of your arteries. Arteries are blood vessels that carry blood away from your heart to other parts of the body. Each time your heart beats, it pumps blood to the arteries. If the pressure in your arteries becomes too high, you have high blood pressure . High blood pressure can put extra stress on your organs. This can lead to heart attack, heart failure, stroke and kidney failure.
Some women have high blood pressure before they get pregnant. Others have high blood pressure for the first time during pregnancy. About 8 in 100 women have some kind of high blood pressure during pregnancy. If you have high blood pressure, talk to your health care provider. Managing your blood pressure can help you have a healthy pregnancy and a healthy baby.
What Are High Blood Pressure Complications During Pregnancy
Complications from high blood pressure for the mother and infant can include the following:
- For the mother:preeclampsiaexternal icon, eclampsiaexternal icon, stroke, the need for labor induction , and placental abruption .1,4,5
- For the baby:preterm delivery and low birth weight .1,6 The mothers high blood pressure makes it more difficult for the baby to get enough oxygen and nutrients to grow, so the mother may have to deliver the baby early.
Discuss blood pressure problems with your health care team before, during, and after pregnancy.
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Questions For Your Doctor
- Im pregnant and have high blood pressure. How great is my risk of developing gestational hypertension or preeclampsia?
- Is there anything I can do to reduce my risk?
- Will medicines help me?
- How often will I need to see you for appointments?
- What are my treatment options?
- Will I need bed rest?
- Will I need a C-section? Or can I have a vaginal birth?