Journal Club - Hypertension Control During Pregnancy Crucial, Validates a Large Trial
Written By : Dr. Nandita Mohan
Medically Reviewed By : Dr. Kamal Kant Kohli
Published On 2022-04-25 04:00 GMT | Update On 2022-04-25 10:18 GMT
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High blood pressure, is very common and it is even more common in pregnancy. high blood pressure happens in 1 in every 12 to 17 pregnancies among women ages 20 to 44. However, with good blood pressure control, you and your baby are more likely to stay healthy.
according to a large, open-label, randomized trial, pregnant women with even mild hypertension should receive blood pressure–lowering medications to reduce the likelihood of adverse outcomes for the mother and the child, Treating to the blood pressure goal in this study reduced the risk of adverse events associated with pregnancy but did not impair fetal growth, reported at the annual scientific sessions of the American College of Cardiology.
In this trial, 2,408 pregnant women with chronic mild hypertension defined as a blood pressure of 160/90 mm Hg were randomized to treatment with a goal blood pressure of less than 140/90 mm Hg or no treatment unless the blood pressure rose to at least 160/105.
All women had singleton pregnancies. Severe hypertension (at least 160/105 mm Hg) was an exclusion criterion, as were several comorbidities, such as kidney disease. For the composite primary outcome of severe preeclampsia, medically indicated preterm birth at less than 35 weeks of gestation, placental abruption, or fetal/neonatal death, the treatment of hypertension versus no treatment showed a relative risk reduction of 18%.
An increase in preeclampsia risk in women whose fetus was small for gestational age (SGA), a theoretical consequence of reductions in arterial pressure, was not seen. Researchers concluded that there has to be protocols for treating mild hypertension in pregnancy and that the American College of Obstetricians and Gynecologists (ACOG) is evaluating these data for changing their current guidelines for managing hypertension during pregnancy.
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