Treatment of high blood pressure during pregnancy appears to be safe for many women, and serious without increasing the risk to fetuses and newborns, according to a new American Heart Association scientific statement published today in the Journal of the Association. May reduce risk of mothers with high blood pressure high blood pressure,
The scientific statement is an analysis by current research experts and may be useful for future clinical practice guidelines. In this statement, “Hypertension during pregnancy: diagnosis, blood pressure targets, and drug therapy,” obstetrics and gynecology, maternal and fetal medicine, cardiology, nephrology specialists, hypertension internal medicine, reviewed and analyzed quality studies. Gone: High blood pressure Meanwhile pregnancy includes preeclampsia and preeclampsia/pre-eclampsia.
According to the latest American Heart Association data, high blood pressure during pregnancy, defined as systolic blood pressure above 140 mm Hg (the highest blood pressure measurement), is the second most common cause of maternal death in the world. In severe cases, the mother has a higher risk of cardiovascular complications during or soon after the baby is born and for many years after the pregnancy. High blood pressure during pregnancy increases the risk of complications in the offspring such as premature birth, low birth weight and low birth weight babies. The incidence of hypertension during pregnancy is increasing worldwide, and the data disproportionately impact women of various racial and ethnic backgrounds in the United States, particularly blacks, Native Americans, or Alaska Natives. indicates giving.
The goals of treatment during pregnancy include the prevention of severe hypertension and the prevention of premature birth to give the fetus time to mature before the baby is born.
“For decades, the benefits of treating blood pressure for pregnant women were unclear, and there were concerns about fetal well-being from exposure to antihypertensive drugs,” said Besna D., chair of the statement-writing group. Garovich said. Said the doctor of medicine. , professor of medicine, chair of the department of kidney disease and hypertension, co-opted in the Mayo Clinic obstetrics and gynecology department in Rochester, Minnesota. “Through a comprehensive review of the existing literature, we see new evidence that treatment of hypertension during pregnancy is safe and effective and may be beneficial at lower thresholds than previously thought. Reassuring. useful for research.
According to the statement, among high-income countries, the United States has the highest maternal mortality rate associated with hypertension. Heart disease, including stroke and heart failure, currently accounts for more than half of maternal deaths in the United States, and hospitalizations for pregnancy-related stroke increased by more than 60% between 1994 and 2011. Preeclampsia which occurs during pregnancy with high blood pressure. According to the American Heart Association, it affects 5% to 7% of pregnancies and affects 70,000 people worldwide each year, with signs of liver and kidney problems such as protein in the urine. These are the cause of maternal death and 500,000 fetal deaths.
“Given the increasing number of cases of hypertension during pregnancy and complications related to hypertension, this problem has become a public health crisis, especially among women of racially and ethnically diverse backgrounds.” “There is,” Garovich he said.
Although the definition of hypertension in the general population is established at 130/80 mmHg, the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) Guideline for the Prevention, Detection, Assessment and Management of Adult Hypertension, defines most guidelines around the world. We do. High blood pressure as 140/90 mmHg during pregnancy.
There is a lack of consensus on when to start treatment for high blood pressure during pregnancy because of concerns about how the drug affects the fetus. Some health advocates recommend starting treatment when blood pressure measurements during pregnancy range from 140/90 mm Hg (Canadian guidelines) to 160/110 mm Hg (US guidelines).
The new statement provides evidence that hypotension therapy for preeclampsia significantly reduces the incidence of severe hypertension. Further research is needed to determine to some extent whether treating low-threshold hypertension can reduce serious hypertension complications, i.e. organ damage and hypertensive emergencies. Reducing severe hypertension may be especially important in communities that lack the resources and expertise to respond to hypertensive emergencies, the authors write.
“Future studies are needed to consider whether lowering the threshold for treatment of hypertension during pregnancy leads to safe and timely blood pressure control and avoids immediate delivery due to uncontrolled hypertension. There is, Garovic said.
So far, the latest research suggests that treating high blood pressure with high blood pressure medications during pregnancy does not adversely affect fetal growth or development. Preventing high blood pressure during pregnancy supports the health of the mother during and after pregnancy. It is well known that people with high blood pressure during pregnancy are more likely to develop persistent hypertension after pregnancy than those with normal blood pressure during pregnancy. This statement reinforces recent studies suggesting that lifestyle changes before and during pregnancy can improve maternal and fetal outcomes.
- Dietary changes before and during pregnancy can limit weight gain and improve pregnancy outcomes.
- Exercising during pregnancy can reduce the risk of preeclampsia by about 30% and the risk of preeclampsia by about 40%.
This statement also focuses on these concerns.
- There is new evidence that postpartum (postpartum) hypertension may be associated with serious maternal health problems.
- Current science suggests that clinicians need to individualize treatment decisions by considering risk factors and patient preferences.
- The care of women with high blood pressure during pregnancy is often complex and a multidisciplinary team of medical professionals may be beneficial.
“Future clinical trials are needed to address the question of when to start treatment for high blood pressure during pregnancy,” Garovic said. In addition, the close collaboration between the American Heart Association and the American Society of Obstetrics and Gynecology optimizes the diagnosis and treatment of hypertension during pregnancy and improves immediate and long-term outcomes for many women who develop high blood pressure during pregnancy. It does. It helps.”
This scientific statement was made by a volunteer writing group on behalf of the Hypertension Council of the American Heart Association. Council on the Kidney of Cardiovascular Science Subcommittee. Council on arteriosclerosis, thrombosis and vascular biology. Council on the health of lifestyle and cardiovascular metabolism. Peripheral Vascular Disease Council; and the Stroke Council. The American Heart Association’s scientific statement helps raise awareness of heart disease and stroke issues and facilitates informed medical decisions. The scientific statement outlines what is currently known about the subject and areas that require additional research. Scientific statements inform the development of guidelines, but do not recommend treatment. The American Heart Association’s guidelines provide the association’s official clinical practice recommendations.
Co-authors are Vice-Chairs Phyllis August, MD and MPH. Ralph Dechend, MD; S Anantha Karumanchi, MD; Susan McMurtry Baird, DNP, RN; Thomas Easter Ring, MD; Laura A. Magee, MD; Sarosh Rana, MD, MPH; Jane V. Barmant, MBCh.B, M.Sc. The author’s disclosure is included in the manuscript.
Changing definition of hypertension may identify high-risk pregnancies
for more information:
Hypertension during pregnancy: diagnosis, blood pressure targets, and pharmacotherapy: scientific statement of the American Heart Association, high blood pressure (2021). www.ahajournals.org/doi/10.116… HYP.0000000000000208
American Heart Association
Citation: Treatment of hypertension during pregnancy is safe and prevents maternal cardiovascular risk (December 15, 2021) 2021
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Treatment of hypertension during pregnancy is safe and prevents maternal cardiovascular risk
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