Does severity of pre-existing chronic hypertension affect preeclampsia severity?
Defining the risk profile of women with stage 1 hypertension: a "time to preeclamptic event" analysis
The American College of Obstetricians and Gynecologists (ACOG) recognize that pre-existing hypertension (having high blood pressure before pregnancy) is a well-known risk factor for preeclampsia. In 2017, the American Heart Association (AHA) updated the criteria for what actually diagnoses someone with high blood pressure- lowering the values- so that a blood pressure measurement over 130/80 mmHg (outside of pregnancy) is now considered Stage 1 Hypertension. But ACOG has not yet changed their guidelines for cutoffs during pregnancy, leaving the line at 140/90 even though that would now be considered Stage 2 Hypertension by the AHA.
In this study, researchers asked if the timing during pregnancy for developing a hypertensive disorder of pregnancy is different for women without hypertension vs. stage 1 hypertension vs. stage 2 hypertension. Among the 3,000 women studied, researchers found that women with stage 1 hypertension before they became pregnant had a doubled risk for preeclampsia compared to women entering pregnancy with normal blood pressure. Researchers also found that the group of women with stage 1 hypertension developed a hypertensive disorder of pregnancy (like preeclampsia) about a week earlier in pregnancy compared to women without high blood pressure before pregnancy. These results suggest the new blood pressure guidelines from the AHA for non-pregnant patients should be kept in mind by OB/GYNs when taking care of pregnant patients, as stage 1 hypertension is becoming a well-established risk factor for preeclampsia and may hint at earlier presentation of the syndrome.
LINK: https://pubmed.ncbi.nlm.nih.gov/33878494/
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