Low-dose aspirin could help pregnant women with high blood pressure avoid a dangerous condition

May 25, 2018, American Heart Association
Low-dose aspirin could help pregnant women with high blood pressure avoid a dangerous condition
Credit: American Heart Association

A daily dose of aspirin could help pregnant women in the first stage of high blood pressure avoid a condition that puts both mother and baby in danger, according to a new study.

New guidelines lowering the threshold for what defines high blood pressure pose a quandary for doctors who treat pregnant women at risk for preeclampsia. High blood pressure is one risk factor for that condition, which can cause stroke and seizures; premature separation of the placenta; damage to the mother's kidneys and liver; and premature birth and low birth weight.

And while women at high risk for preeclampsia already are given low-dose aspirin as a preventive measure, now doctors must decide whether to give it to women who were not considered candidates for the drug under previous blood pressure guidelines.

"We are going to have a lot more patients that come in with the new high blood pressure diagnosis, and we needed to figure out what to do. What is their risk for preeclampsia? Is it the same?" said Dr. Alisse Hauspurg, who is in her second year of a fellowship in maternal-fetal medicine at the Magee-Womens Hospital of the University of Pittsburg Medical Center.

She led the University of Pittsburg study, published Friday in the American Heart Association journal Hypertension, which shows low-dose aspirin could help prevent preeclampsia in women in the first stage of high blood pressure. The blood pressure guidelines issued in November now consider a reading of 130 on the top or 80 on the bottom to be stage 1 hypertension. In the past, that standard was 140/90.

Hauspurg's research showed taking a low-dose aspirin reduced the risk of developing preeclampsia by 39 percent in women with stage 1 hypertension compared to those taking a placebo.

"I was really surprised that the difference is as big as it is," Hauspurg said. The study was a second look at data collected in a trial investigating low-dose aspirin to prevent preeclampsia in high-risk women.

Credit: American Heart Association

However, aspirin didn't significantly reduce the likelihood of preeclampsia in women who didn't have high blood pressure but who were still at high risk for the condition. These included women with insulin-dependent diabetes and previous preeclampsia, among other risk factors, for whom preeclampsia risk dropped by just 3 percent.

The women were recruited between 1989 and 1992 and were given 60 milligrams of aspirin a day during pregnancy. Today, a dose of 81 to 160 milligrams is more common, Hauspurg said. The original study included 2,539 women but only 1,020 were used in this analysis, which did not include women carrying multiple fetuses and who had pre-existing hypertension that is now classified as stage 2.

The substantial difference in the outcome between women with and those without it highlights the need for more studies, doctors said. In fact, doctors said they don't know what causes preeclampsia or how aspirin affects it.

Preeclampsia affects about 3.4 percent of pregnancies in the United States and causes 10 percent to 15 percent of maternal deaths worldwide, according to estimates from the National Institutes of Health.

"We are up against a problem we really don't understand," said Dr. Monique Chireau, an assistant professor of obstetrics and gynecology at Duke University School of Medicine, who was not involved in the study.

Chireau said the findings suggest there may be many pathways to preeclampsia and that aspirin may not work on all of them.

Hauspurg cautioned that one study isn't enough to stop giving aspirin to all at risk of preeclampsia. "I don't want to jump to conclusions," she said.

For now, Hauspurg said the study could help create more targeted trials. For example, statins and metformin are being tested as potential risk-reduction agents, although those drugs aren't as safe as aspirin, she said. "Maybe we target new trials to populations that don't benefit from ."

Explore further: Give aspirin to all pregnant women at risk of preeclampsia, US experts say

More information: Alisse Hauspurg et al. Aspirin Effect on Adverse Pregnancy Outcomes Associated With Stage 1 Hypertension in a High-Risk Cohort, Hypertension (2018). DOI: 10.1161/HYPERTENSIONAHA.118.11196

Related Stories

Give aspirin to all pregnant women at risk of preeclampsia, US experts say

September 9, 2014
(HealthDay)—Women at high risk for the pregnancy complication known as preeclampsia should take low-dose aspirin daily after 12 weeks of pregnancy, a panel of U.S. health experts recommends.

Research offers recommendations for use of aspirin to prevent preeclampsia

December 16, 2015
To prevent preeclampsia, new research suggests that low-dose aspirin should be given prophylactically to all women at high risk (those with diabetes or chronic hypertension) and any woman with two or more moderate risk factors ...

Aspirin advised for women at high risk for pregnancy complication (Update)

April 8, 2014
(HealthDay)—Pregnant women at high risk for the serious condition called preeclampsia should take low-dose aspirin every day after their first trimester, according to a new draft recommendation by an influential U.S. panel ...

Marked increase in cardiovascular risk factors in women after preeclampsia

February 28, 2018
Women diagnosed with preeclampsia during pregnancy were significantly more likely to develop high blood pressure, diabetes or high cholesterol within five years compared with women who did not have preeclampsia, in a study ...

Preeclampsia screening method found superior to current tests

March 14, 2018
New research highlights a more accurate way to screen for preeclampsia in pregnant women than currently recommended methods. Published early online in Ultrasound in Obstetrics & Gynecology, the study challenges the UK's current ...

Pre-pregnancy heart abnormalities may predict recurrent preeclampsia risk

February 22, 2016
Women who had pregnancy-related high blood pressure multiple times had recognizable heart abnormalities between pregnancies that could help predict their risk for heart and blood vessel disease during subsequent pregnancies ...

Recommended for you

People who walk just 35 minutes a day may have less severe strokes

September 19, 2018
People who participate in light to moderate physical activity, such as walking at least four hours a week or swimming two to three hours a week, may have less severe strokes than people who are physically inactive, according ...

Inflammation critical for preventing heart attacks and strokes, study reveals

September 19, 2018
Inflammation, long considered a dangerous contributor to atherosclerosis, actually plays an important role in preventing heart attacks and strokes, new research from the University of Virginia School of Medicine reveals.

Effective drug delivery to heart with tannic acid

September 18, 2018
Typical methods of drug delivery to the heart require surgical procedures involving incisions in the chest wall and bones. To efficiently treat cardiovascular and related vascular diseases without surgery, a KAIST research ...

Daily low-dose aspirin found to have no effect on healthy life span in older people

September 16, 2018
In a large clinical trial to determine the risks and benefits of daily low-dose aspirin in healthy older adults without previous cardiovascular events, aspirin did not prolong healthy, independent living (life free of dementia ...

Financial incentives for cholesterol control may be cost-effective

September 14, 2018
A program that offered financial incentives to both patients and their physicians to control low-density lipoproteins (LDL) cholesterol could be a cost-effective intervention for patients at high risk of cardiovascular disease ...

Apple's smartwatch has a heart monitor now

September 13, 2018
There will soon be another way to monitor your heart—from your wrist.

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.