High Blood Pressure In Pregnancy Linked To Later Health Risks
By Kathryn Doyle, Reuters Health
3 Min Read
Women with slightly elevated blood pressure during pregnancy could be more likely to develop so-called metabolic syndrome later, Chinese researchers say.
Metabolic syndrome a combination of traits and symptoms such as abdominal fat and high blood sugar is a strong predictor of heart disease and diabetes. So blood pressure at the high end of normal in pregnancy could be an early warning sign, according to the study authors.
The optimal blood pressure levels in pregnant women remain an open question, said lead author Dr. Jian-Min Niu of Guangdong Women and Children Hospital in Guangzhou.
In general, healthy blood pressure usually falls at or below 120/80 mmHg, Niu said. The threshold for high blood pressure, or hypertension, is 140/90 or greater. The range between healthy and high blood pressure is sometimes called prehypertension because readings at the high end of normal may be a stage on the way to full-fledged hypertension.
In many countries, every pregnant woman has at least 10 routine checkups, Niu told Reuters Health by email. However, they will not be informed of risk unless the blood pressure level is at or greater than 140/90 mmHg.
The researchers studied 506 pregnant women with no history of high blood pressure or symptoms of diabetes, measuring their blood pressure, weight and other health metrics several times during pregnancy and for up to a year and a half after they gave birth.
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.
Eclampsia And Hellp Syndrome
Pregnancy-induced high blood pressure and preeclampsia can lead to serious and life-threatening conditions like eclampsia and HELLP syndrome.
Eclampsia: This is when blood pressure in pregnancy rises so high that it causes seizures or coma in the mother. Sixty percent of eclampsia comes on during pregnancy, 20% during delivery, and 20% after delivery.
HELLP syndrome: This acronym stands for hemolysis, elevated liver enzymes, and low platelet count. In this condition, your body destroys its own red blood cells, liver cells are damaged, and you may bleed too easily. Seventy percent of cases happen during pregnancy and 30% after delivery.
The terms preeclampsia and eclampsia sound like you need to have preeclampsia before getting eclampsia. But thats not always true. Some women with eclampsia dont have any symptoms of high blood pressure or preeclampsia before they start experiencing seizures. The same thing goes for HELLP syndrome. It can appear without warning.
Luckily, these conditions are rare. Eclampsia happens in less than 0.1% of pregnancies in the United States, while HELLP happens in 0.1-0.2 % of all pregnancies. Rates are higher for black and some latino women, as well as women who have pregnancy-induced high blood pressure and preeclampsia.
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How Can I Reduce My Risk Of Getting Preeclampsia
For people with risk factors, there are some steps that can be taken prior to and during pregnancy to lower the chance of developing preeclampsia. These steps can include:
- Losing weight if you have overweight/obesity .
- Controlling your blood pressure and blood sugar .
- Maintaining a regular exercise routine.
- Getting enough sleep.
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Pregnancy And Heart Health
In general, pregnancy puts stress on a womans heart and circulatory system, the Mayo Clinic reports.
Because blood volume goes up 30 to 50 percent to support the baby, a pregnant womans heart pumps more blood per minute and her heart rates increase.
Women who develop early-onset preeclampsia are more likely to have thickening in their hearts left ventricle one month after delivery and therefore are at the greatest risk for developing heart disease, according to American Heart Association research presented last year.
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Additional Tips For Managing Hypertension
It is crucial to receive early and regular prenatal medical care to keep your health on track. High bp during pregnancy and natural remedies may be all you need for your body, but if your doctor prescribes medication to keep your blood pressure in check, be sure to take it daily as prescribed. Low-dose aspirin may even be recommended as preventative care for people at risk for preeclampsia. Remember, only start or stop a medication or treatment, whether it is natural or otherwise, after speaking with your doctor. It is essential to remember that even natural things can be harmful to some people.
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Changes In Blood Pressure During Pregnancy
As a woman progresses in her pregnancy, her blood pressure may change or return to pre-pregnancy levels. There are a few possible reasons for this.
The amount of blood in a womans body increases. According to the journal Circulation, a womans blood volume increases by as much as 45 percent during pregnancy. This is extra blood that the heart must pump throughout the body.
The left ventricle becomes thicker and larger. This temporary effect allows the heart to work harder to support the increased blood volume.
The kidneys release increased amounts of vasopressin, a hormone that leads to increased water retention.
In most cases, high blood pressure during pregnancy will decrease after the baby is delivered. In cases where blood pressure remains elevated, your doctor may prescribe medication to get it back to normal.
Who Is At Risk For Preeclampsia
You are at higher risk of preeclampsia if you:
- Had chronic high blood pressure or chronic kidney disease before pregnancy
- Had high blood pressure or preeclampsia in a previous pregnancy
- Damage to your kidneys, liver, brain, and other organ and blood systems
- A higher risk of heart disease for you
- Eclampsia, which happens when preeclampsia is severe enough to affect brain function, causing seizures or coma
- HELLP syndrome, which happens when a woman with preeclampsia or eclampsia has damage to the liver and blood cells. It is rare, but very serious.
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High Blood Pressure And Pregnancy
High blood pressure, or hypertension, does not usually make you feel unwell, but it can sometimes be serious in pregnancy.
Your midwife will check your blood pressure at all your antenatal appointments.
If you are pregnant and have a history of high blood pressure, you should be referred to a specialist in hypertension and pregnancy to discuss the risks and benefits of treatment.
If you develop high blood pressure for the first time in pregnancy, you will be assessed in a hospital by a healthcare professional, usually a midwife, who is trained in caring for raised blood pressure in pregnancy.
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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How Is Blood Pressure Measured
Blood pressure is shown as 2 numbers:
- The top number is the highest pressure in your arteries when your heart pumps blood to the rest of your body.
- The bottom number is the lowest pressure when your heart rests between heartbeats.
Blood pressure is normally written as the top number over the bottom number, such as 120/80.
High blood pressure may be considered to be 140/90 mmHg or higher. However, it is difficult to give an example of a high blood pressure reading, because it depends on the individual. The level of blood pressure that is high for you depends on lots of different factors and your overall risk of heart attack or stroke. Generally, the lower your blood pressure, the better. If you have a history of heart disease, diabetes or a high risk of heart attack or stroke, its recommended you lower your blood pressure to less than 130/80. See who needs to get their blood pressure checked?
What Can You Do To Take Care Of Yourself
To help control your blood pressure and have a healthy pregnancy:
- Don’t smoke. This is one of the best things you can do to help your baby be healthy. If you need help to quit smoking, talk to your doctor.
- Be sure to go to all of your prenatal checkups so your doctor or midwife can check your blood pressure. You may also want to check your blood pressure at home.
- Gain an amount of weight that is healthy for you. Your doctor or midwife can help you set a pregnancy weight goal.
- If your doctor says it’s okay, get regular exercise during pregnancy. Walking or swimming several times a week can help lower blood pressure. And it’s good for you and your baby.
- Try to keep your stress level low. This may be hard to do, especially if you continue to work, have young children, or have a hectic schedule. But try to find some time to relax.
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When Hypertension Becomes Preeclampsia
When high blood pressure starts to affect other organs, like your kidneys or liver, it is called preeclampsia. Another sign of preeclampsia is too much protein in the urine. Preeclampsia can happen during pregnancy or in the weeks after you give birth. It is a very serious condition.
If your condition worsens, you may develop what we call severe features of preeclampsia, such as blood pressure that exceeds 160 or 110 , severe headaches that dont go away, and fluid in the lungs. Preeclampsia can lead to seizures, a condition called eclampsia.
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Low Blood Pressure Complications
While many women who have low blood pressure prior and during pregnancy do not have any related issues, there are some complications to be aware of.
Some symptoms of low blood pressure include:
- Rapid or shallow breathing
One of the most concerning complications is dizziness because it can lead to fainting, falling, and injury, secondary to the fall. Additionally, research has shown a link between low blood pressure and increased symptoms of morning sickness.
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Preventing High Blood Pressure During Pregnancy
Common risk factors for high blood pressure, such as obesity, can be minimized through diet and exercise.
During pregnancy, its normal to gain some weight. If youre concerned, talk to your doctor about a target weight gain and ways to stay within a range thats healthy for you.
Dietary guidelines for pregnant women vary from person to person. A nutritionist can help create a meal plan thats designed for your specific height and weight.
Avoid smoking and drinking alcohol. Both are known to raise blood pressure and to cause other complications during pregnancy.
Salt is important during pregnancy and its usually not necessary to limit salt intake, even for women with high blood pressure. Restricting salt too much is harmful for pregnant women and can impact fetal growth and development.
Pregnancy causes hormone shifts as well as psychological and physical changes. This can bring on stress, which can make high blood pressure harder to manage. Try stress reduction techniques such as yoga and meditation.
Some traditional blood pressure medications can cause problems in pregnant women.
These medications for lowering blood pressure are typically not recommended during pregnancy:
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