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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Each quarter, our team of researchers reviews the most current studies related to hypertensive disorders of pregnancy and selects those studies they feel will be of greatest interest to our community to summarize.
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