Blood Pressure Guidelines 2019 May Increase Gestational Hypertension Rates

Women with high blood pressure during pregnancy are at greater risk of stroke and cardiac events after delivery.

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The American Heart Associating (AHA) and the American College of Cardiology (ACC) revised the clinical guidelines for high blood pressure, which lowered the figures of systolic from 140 mmHg to 120 mmHg and diastolic from 90 mmHg to 80 mmHg. However, the new guidelines were not applied to pregnant women.

In a recent study, Chinese researchers considered the adapted guidelines to estimate hypertension rates among pregnant women. The researchers found that over 25 percent had gestational hypertension compared to the previous estimation of only 4.3 percent under the old high blood pressure guidelines.

The study was published in July in the Circulation Research.

Lead study author Jie Hu said, “Timely, accurate diagnosis of gestational hypertension is crucial for preventing associated conditions for pregnant women like preeclampsia and postpartum chronic hypertension.”

“Infants born to women with gestational hypertension are more susceptible to preterm birth and adverse long-term health outcomes like young adulthood cardiovascular disease,” continued Hu.

They examined both systolic and diastolic blood pressure data of more than 16,000 Chinese women at a maternal and child hospital at different points of their pregnancies.

The Centers for Disease Control and Prevention (CDC) says pregnant women with high blood pressure are often diagnosed after 20 weeks of their pregnancy. Although the high blood pressure level normally falls after delivery, some women develop chronic hypertension.

The CDC also says that women who have gestational hypertension are at a greater risk of having a stroke or other cardiovascular events after delivery. The agency recommends calling 911 if pregnant women experience symptoms of nausea, vomiting, and sudden weight gain, or any other symptoms particular to gestational hypertension, such as headaches, swelling, vision changes, or urinary troubles.  

The researchers said that they will conduct more studies in order to compare these findings to a more ethnically and racially diverse pool of subjects outside China. Hu said, “Incorporating the 2017 ACC/AHA guidelines into prenatal care practice could improve detection of high blood pressure during pregnancy and the effort to reduce adverse maternal and neonatal outcomes in the perinatal period that are related to gestational hypertension.”