Severe pre-eclampsia can mask hypertension after pregnancy

Severe pre-eclampsia can mask hypertension after pregnancy

New research from the American Heart Association has found that women who have severe pre-eclampsia following pregnancy can have lingering hypertension which goes unnoticed.

Pre-eclampsia, a condition where a woman develops hypertension and elevated protein in the urine during pregnancy, occurs in 3-5% of pregnancies in the developed world.

Recent studies have shown that women with pre-eclampsia are more likely to have high blood pressure post-pregnancy than those with normal blood pressure during pregnancy.

What did the study entail?

There were 200 pregnant women studied that were diagnosed with severe pre-eclampsia, which is defined by such criteria as a systolic blood pressure of 160mmHg or higher and/or diastolic blood pressure of 110mmHg or higher.

Researchers then followed the women for one year after their pregnancies, monitoring blood pressure during the day and night, as well as taking blood pressure readings in the clinic.

What did they find?

  •  Over 41% of the women had high blood pressure in the year after pregnancy;
  • Masked hypertension was the most common type of hypertension (17.5%), which is normal blood pressure in the doctor’s office but high readings outside of the office. This was followed by sustained hypertension (14.5%), then white coat hypertension (9.5%);
  • If in-clinic readings were the only ones being used, then doctors would have missed 56% of the women with high blood pressure;
  • Night-time hypertension, which increases risk of heart disease and stroke, affected 42.5% of the women; and
  • 45% of the women were found to have an insufficient decrease in blood pressure from daytime to night-time, which is unhealthy.

What are the potential long-term risks?

According to Laura Benschop, MD, study author and researcher in obstetrics and gynaecology at Erasmus Medical Centre, Rotterdam, the Netherlands, women with severe pre-eclampsia can be seven times more susceptible to developing future cardiovascular disease compared to women with normal blood pressure during pregnancy.

Benschop said: “The problem is high blood pressure after pregnancy often goes unnoticed because many of these women have normal blood pressure readings in the doctor’s office.

“We aimed to determine how common it is for women who have pre-eclampsia to have high blood pressure in the year after pregnancy, by looking at more than just their blood pressure readings in the doctor’s office.”

Monitoring blood pressure

Benschop added: “Our findings suggest women who have high blood pressure during pregnancy should continue to monitor their blood pressure long after they’ve delivered their babies. It’s not only important to monitor blood pressure in the doctor’s office, but also at different times of the day and night, at home.

“We’ve shown here that high blood pressure comes in many forms after pregnancy. Women who know their numbers can take the proper steps to lower their blood pressure and avoid the health consequences of high blood pressure later in life.”

The study was published in the journal Hypertension.

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