Severe pre-eclampsia often leads to undetected high blood pressure after pregnancy

February 5, 2018, American Heart Association

Lingering hypertension is common and may go unnoticed among women who have severe pre-eclampsia during pregnancy, according to new research in the American Heart Association's journal Hypertension.

Pre-eclampsia, which is when a woman develops hypertension and elevated protein in the urine during pregnancy, occurs in three to five percent of pregnancies in the developed world. Recent studies have shown that with pre-eclampsia are more likely than women with normal blood during pregnancy to have high blood pressure post-pregnancy.

Women with severe pre-eclampsia can be seven times more susceptible to develop future cardiovascular disease compared to women with a normal blood pressure during pregnancy, according to study author Laura Benschop, M.D., a researcher in obstetrics and gynecology at Erasmus Medical Center, Rotterdam, the Netherlands.

"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," Benschop said. "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."

Benschop and colleagues studied 200 women who during their pregnancies were diagnosed with severe pre-eclampsia, defined by such criteria as a of 160 mmHg or higher and/or of 110 mmHg or higher. They followed the women for one year after their pregnancies, monitoring blood pressure during the day and night and taking blood pressure readings in the clinic.

They found:

  • More than 41 percent of the women in the study had high blood pressure in the year after pregnancy.
  • The most common type of hypertension detected (17.5 percent) was masked hypertension, which is in the doctor's office, but high readings outside of the office; followed by sustained hypertension (14.5 percent); then, (9.5 percent), which occurs when people have higher at the doctor's office than outside the clinic setting.
  • If the ambulatory readings hadn't been taken and only in-clinic readings were used, doctors would have missed 56 percent of the women with high blood pressure.
  • Forty-six percent of the women studied had an insufficient decrease in blood pressure from daytime to nighttime, which is unhealthy.
  • Night-time hypertension, which increases the risk of heart disease, stroke and death, affected 42.5 percent of women in the study.

"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," Benschop said. "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."

This study has limitations, including that the findings might not be applicable across races and income levels. The women in this study were predominately highly educated and Caucasian.

According to new hypertension treatment guidelines recently released by the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, is now defined as readings of 130 mm Hg and higher for the systolic measurement, or readings of 80 and higher for the diastolic measurement. That is a change from the old definition of 140/90 and higher, reflecting complications that can occur at those lower numbers.

Explore further: Around-the-clock monitoring may unmask hypertension in African-Americans

More information: Hypertension (2018). DOI: 10.1161/HYPERTENSIONAHA.117.10338

Related Stories

Around-the-clock monitoring may unmask hypertension in African-Americans

May 16, 2016
Wearing an ambulatory blood pressure monitoring device that measures blood pressure around-the-clock may help identify African Americans who have masked or undetected high blood pressure outside of the doctor's office, a ...

Early onset of pregnancy complication may raise heart risks

September 15, 2017
(HealthDay)—Women who develop pre-eclampsia earlier in pregnancy may be at increased risk for heart problems soon after giving birth, a new study finds.

Hypertensive disorders during pregnancy increase risk for high blood pressure after delivery

January 28, 2016
Women who are diagnosed with hypertensive disorders while pregnant are more than twice as likely to develop high blood pressure in the first year after delivery as women who did not have any pregnancy-related hypertension, ...

Pregnant women with hypertension and their siblings face increased risk of heart disease

August 27, 2015
High blood pressure during pregnancy is a risk factor for future hypertension and cardiovascular disease, but it's not clear if this increased risk is because these women are more likely to have a family history of heart ...

Blood pressure: know your numbers

April 18, 2017
(HealthDay)—Having high blood pressure makes you more likely to have heart disease or a stroke. But because high blood pressure doesn't usually cause warning symptoms, you could be at risk without even knowing it.

Clinic readings may underestimate blood pressure during daily activities

December 5, 2016
Around the clock monitoring during daily activity revealed masked, or undetected, high blood pressure among otherwise healthy adults who had normal readings in the clinic, according to new research in the American Heart Association's ...

Recommended for you

Proteins cooperate to break up energy structures in oxygen starved heart cells

November 19, 2018
During a heart attack, the supply of oxygen to heart cells is decreased. This reduced oxygen level, called hypoxia, causes the cell's powerhouses, the mitochondria, to fragment, impairing cell function and leading to heart ...

Bullying and violence at work increases the risk of cardiovascular disease

November 19, 2018
People who are bullied at work or experience violence at work are at higher risk of heart and brain blood vessel problems, including heart attacks and stroke, according to the largest prospective study to investigate the ...

Genetic analysis links obesity with diabetes, coronary artery disease

November 16, 2018
A Cleveland Clinic genetic analysis has found that obesity itself, not just the adverse health effects associated with it, significantly increases the risk of Type 2 diabetes and coronary artery disease. The paper was published ...

Non-coding genetic variant could improve key vascular functions

November 15, 2018
Atherosclerotic disease, the slow and silent hardening and narrowing of the arteries, is a leading cause of mortality worldwide. It is responsible for more than 15 million deaths each year, including an estimated 610,000 ...

Study of two tribes sheds light on role of Western-influenced diet in blood pressure

November 14, 2018
A South American tribe living in near-total isolation with no Western dietary influences showed no increase in average blood pressure from age one to age 60, according to a study led by researchers at Johns Hopkins Bloomberg ...

Heart failure patients shouldn't stop meds even if condition improves: study

November 13, 2018
(HealthDay)—There's bad news for heart failure patients with dilated cardiomyopathy who'd like to stop taking their meds.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.