JUN 29, 2016

New Standard for Hypertension in Pregnant Women

WRITTEN BY: Kara Marker
When determining whether a person is at risk for health problems from high blood pressure, there are sometimes different guidelines for men and women, but there are no current guidelines that establish a specific guideline for pregnant women. Researchers from the American Heart Association (AHA) now have reason to believe that guidelines for pregnant women should be written and shared with the public.
 
A new study published in the AHA journal Hypertension reveals that pregnant women are uniquely at risk for developing metabolic syndrome after experiencing higher than normal blood pressure levels during pregnancy. A healthy blood pressure is considered to be under 120 millimeters of mercury (mm Hg) systolic over 80 mm Hg diastolic for all adults over the age of 20. When blood pressure levels reach 140 over 90 and higher, medical professionals consider it to be “high,” putting these people at risk for a myriad of conditions like heart attack, congestive heart failure, and stroke.
 
What people often do not know is that blood pressure levels between 120-139 over 80-89 is dubbed “pre-hypertension.” While doctors may not consider blood pressure levels in pre-hypertension an immediate risk for healthy adults, the new AHA study shows that pregnant women with pre-hypertension are at a higher risk for metabolic syndrome.
 
Metabolic syndrome is a broad term that scientists use to describe a series of risk factors that elevate a person’s risk for heart disease. When a person has multiple of the risk factors listed below, their status of “metabolic syndrome” is known to increase their risk for developing cardiovascular disease and other health conditions.
  1. Abdominal obesity: for women, a waist circumference of 35 inches and higher
  2. Triglyceride level: 150 milligrams per deciliter of blood and higher
  3. High-density lipoprotein levels: for women, less than 50 milligrams per deciliter
  4. Systolic blood pressure of 130 or greater
  5. Diastolic blood pressure of 85 or greater
  6. Fasting glucose levels of 100 milligrams per deciliter or greater
Jian-Min Niu, MD, of the Department of Obstetrics at Guangdong Women and Children Hospital in China led the AHA study of blood pressure levels in pregnant women. Niu’s team recorded blood pressure changes of over 500 pregnant Chinese women, all with healthy pregnancies, no history of hypertension, and normal levels of blood glucose levels and cholesterol.
 
After taking various measurements throughout the pregnancy and many months following birth, the researchers were able to group women into categories based on their blood pressure levels. 34 percent of women had blood pressure levels closest to normal (120/80), 52 percent had “mid-point normal” blood pressure levels, and 13 percent of women had high enough blood pressure levels to be considered pre-hypertension.
 
From their study of the women during and after their pregnancies, the researchers believe that “patterns of repeated elevations over the course of a pregnancy” can predict a woman’s future risk of developing metabolic syndrome and the conditions that come with it.
 
“Early identification of metabolic risk factors and implementation of lifestyle modifications may help delay the onset of cardiovascular disease that would present itself to 20-30 years after delivery,” Niu explained. The researchers also believe that pregnancy is a “cardiovascular stress test” for women that can express errors in blood pressure regulation, as well as other processes that lead to metabolic syndrome.  Needless to say, the number of women with metabolic syndrome-related diseases continues to grow every year across the globe, and detecting who is at an increased risk due to blood pressure changes during pregnancy will help health officials make the proper interventions to reduce the incidence of disease.
 

 
Sources: AHA, National Heart, Lung, and Blood Institute