High blood pressure or hypertension in pregnancy is diagnosed if the systolic pressure is ≥ 140 mm Hg and the diastolic blood pressure is ≥ 90 mm Hg on two separate blood pressure measurements taken 4 hours apart. High blood pressure pregnancy is a significant contributor to most of the complications and can be life threatening to both the mother and the baby. It can be controlled and managed by making lifestyle changes and with the help of medications.

Risk Factors for High Blood Pressure in Pregnancy

There are certain factors that can increase your risk of developing hypertension during pregnancy. These are:

• If you have a family history of hypertension
• If you are diabetic
• If you are overweight or obese
• If you already suffer from hypertension before pregnancy
• If you are below 20 or over 40 years when you get pregnant
• If you are having multiple babies
• If this is your first pregnancy
• If you smoke or drink alcohol
• If you have resorted to techniques such as IVF (in vitro fertilization) to get pregnant

Types of Hypertension that Can Develop During Pregnancy

During your pregnancy you may be diagnosed with any of the following hypertensive disorders:

1. Chronic Hypertension

You are considered to have chronic hypertension:

• In case you are already suffering from hypertension before you got pregnant
• If you are diagnosed with hypertension within 20 weeks of your pregnancy
• If your hypertension does not disappear by the time your reach your 12 week post-partum check up period

Chronic hypertension has been reported to complicate 5% of all pregnancies. The chances of developing chronic hypertension are higher if you delay child bearing. You are considered to have milder form of chronic hypertension if your systolic pressure is up to 179 mm Hg and your diastolic pressure is 109 mm Hg. However, if your systolic pressure is ≥ 180 mm Hg and diastolic pressure is ≥ 110 mm Hg you are suffering from a severe form of chronic hypertension.   

2. Preeclampsia

Preeclampsia develops when the blood supply to the placenta is not normal because of lack of tolerance of the maternal immune system to the fetus.

Mild preeclampsia occurs in 6% of pregnancies and severe preeclampsia occurs in 1-2% of pregnancies.

You are diagnosed with preeclampsia if you have hypertension or high blood pressure pregnancy and presence of protein in urine after 20 weeks of pregnancy.  

The other symptoms of preeclampsia include:

• Severe headache
• Problems with vision
• Fluid retention leading to swelling of hands, feet, face and ankles
• Vomiting
• Dizziness
• Abdominal pain
• Reduced urination

Although rare, in pregnant women preeclampsia can cause serious complications such as stroke, seizures, water retention in the lungs, heart failure and bleeding in the liver. In preeclampsia, there is reduced blood reaching the fetus, resulting in premature births and associated complications such as learning disabilities, epilepsy and vision and hearing problems.         

3. Preeclampsia with Chronic Hypertension

In this condition, preeclampsia develops in pregnant women who have already been diagnosed with chronic hypertension before their pregnancy. After pregnancy their hypertension aggravates, leading to presence of protein in urine and other complications of preeclampsia.

4. Gestational Hypertension

You are considered to have gestational hypertension or pregnancy induced hypertension if you are diagnosed with hypertension after 20 weeks of your pregnancy.

You are diagnosed:

• If you have had normal blood pressure before your pregnancy but had developed high blood pressure after 20 weeks of pregnancy (systolic pressure ≥ 140 mm Hg and diastolic pressure ≥ 90 mm Hg)
• If there is absence of protein in your urine
• If you do not show any of the symptoms associated with preeclampsia

It has been reported that 50% of women who are diagnosed with gestational hypertension develop preeclampsia. If you are diagnosed with gestational hypertension you will be carefully monitored throughout your pregnancy for hypertension related complications.

What are the Complications with High Blood Pressure Pregnancy?  

• Decreased placental blood flow

Decreased blood flow to the placenta leads to decreased supply of nutrients and oxygen to the fetus. This results in slow growth (intrauterine growth restriction), decreased birth weight and premature birth.  

• Organ injury

Elevated blood pressure can cause damage to kidneys, liver, heart, lungs and brain which can be life threatening.

• Premature delivery

Hypertension can result in premature delivery of the baby to prevent the hypertension related complications from worsening and to prevent further damage.

• Raised risk of heart diseases

If you have had preeclampsia during pregnancy then the risk of suffering from heart diseases in the future is increased.

• Placental abruption

It is a condition where the placenta separates from the inner wall of the uterus causing excessive bleeding. Preeclampsia increases the risk of placental abruption which is a serious life threatening complication for both the mother and the baby. 

How to Manage High Blood Pressure

1. Eat Healthy

• Eat healthy and balanced meals to help maintain normal blood pressure levels during your pregnancy.
• Consume lots of fresh fruits and vegetables and avoid fried foods, fast foods and processed foods.
• Add at least 6-8 servings of whole grains to your diet. There are reports that whole grains in your diet will help reduce your elevated blood pressure levels.
• Avoid tea, coffee and other caffeinated drinks as they can increase your blood pressure. Consume fat free or low fat dairy products as they have been shown to reduce elevated systolic blood pressure. However, avoid cheese as it may increase your sodium intake.  

2. Exercise

You are more prone to suffer from hypertension if you are following an inactive life style. You should start exercising from the time you decide to get pregnant. You should continue exercising throughout your pregnancy after consulting your doctor. 

3. Carefully Monitor Your Weight

If you are overweight or obese you have a higher risk of developing high blood pressure pregnancy. During your pregnancy make sure your weight gain is within the recommended limits. Also ensure that you do not gain weight too fast. Eat healthy foods and exercise regularly to maintain a healthy weight. Regularly monitor your weight.

4. Reduce Stress

Reduce your stress levels during your pregnancy. Reduce your work load to reduce work related stress. Try meditation, yoga and breathing exercises to relax.

5. Monitor Your Salt Intake

The daily recommended salt intake is 2400 mg. However, restricting your intake to 1500 mg can help decrease your blood pressure. Avoid foods such as processed foods, fast foods and certain sports drinks that are high in sodium.

6. Avoid Alcohol and Smoking

If you smoke or drink alcohol you have a higher risk of developing hypertension. Smoking and drinking alcohol can also harm your baby.

7. Increase Your Potassium Intake

Increase your potassium intake by consuming foods rich in potassium such as bananas, orange juice, avocados, cantaloupe and chicken. Consuming 2000 mg of potassium from dietary supplements will help control your hypertension.

8. Follow Medical Instructions

Your doctor may recommend medications or life style changes to control your hypertension. Follow the instructions of your doctor carefully. Do not skip appointments with your doctor or skip medications.

Now you know all about high blood pressure pregnancy.