Researchers Propose Lowering Blood Pressure Guidelines During Pregnancy

Key Takeaways

Lowering the threshold for high blood pressure in pregnancy may help identify more women who are at risk of life-threatening complications, according to new research.

The March study, which was published inJAMA Open Network, explored new parameters of hypertension, or high blood pressure, a metric that is currently confusing for pregnant women.

In 2017, the American College of Cardiology and the American Heart Association changed the definition of hypertension, lowering the threshold from 140/90 mm Hg and above to 130/80 mm Hg and above, lead study authorNatalie A. Bello, MD, MPH, director of research at the Women’s Heart Center at Columbia University Medical Center in New York, tells Verywell.

Hypertension

But, despite these lowered metrics, the American College of Obstetrics and Gynecology did not change the threshold for diagnosing hypertension during pregnancy. That threshold is still at 140/90 mm Hg and higher.

Systolic blood pressure (the top number in a blood pressure reading) measures the pressure in your arteries when your heart beats. Diastolic blood pressure (the bottom number), measures the pressure in your arteries when your heart rests between beats. A normal blood pressure level is considered less than 120/80 mmHg.

For the study, Bello and her colleagues analyzed data of 137,389 pregnancies from 2009 to 2014 to look for hypertension and pregnancy outcomes. When they applied the lowered definition of hypertension from the American College of Cardiology and the American Heart Association, they discovered that the prevalence of hypertension in pregnant women jumped from 10.3% to 28.1%.

What Causes Postpartum Hypertension (and How to Treat It)?

Lowering the Threshold

“The discrepant definitions/thresholds for the diagnosis of hypertension between pregnant and non-pregnant adults can be a source of confusion for patients and clinicians,” Bello says. “We knew that lowering the threshold would increase the prevalence of hypertension, but were unsure how much it would increase, and whether applying that diagnosis would better identify women and their fetuses who are at risk of adverse events such as preeclampsia, or if it would not make a difference.”

Ultimately, Bellow says, using the lowered criteria to diagnose hypertension in pregnant women led to a nearly 21% improvement in identifying women at risk of developing preeclampsia, and a nearly 4% improvement in finding babies at risk for related health issues like small birth weight, preterm birth, and being admitted to the NICU.

What This Means For YouHypertension in pregnancy is a serious and potentially deadly condition. Talk to your doctor about your options if your blood pressure is high during pregnancy. You may benefit from taking low-dose aspirin, even if your blood pressure is borderline.

What This Means For You

Hypertension in pregnancy is a serious and potentially deadly condition. Talk to your doctor about your options if your blood pressure is high during pregnancy. You may benefit from taking low-dose aspirin, even if your blood pressure is borderline.

Hypertension in Pregnancy

Hypertension in pregnancyis generally divided into three categories:

What Is Eclampsia?

The exact cause of preeclampsia is unknown, but women are more at risk when they have certain health factors, including:

Currently, the United States Preventive Services Task Force (USPSTF) recommends that pregnant women have their blood pressure checked at every prenatal care visit.“If the reading is elevated, it should be confirmed with repeated measurements,” Bello says.

List of Blood Pressure Medications

5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bello NA, Zhou H, Cheetham TC, et al.Prevalence of hypertension among pregnant women when using the 2017 American College of Cardiology/American Heart Association blood pressure guidelines and association with maternal and fetal outcomes.JAMA Netw Open. 2021;4(3):e213808. doi:10.1001/jamanetworkopen.2021.3808Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.Hypertension. 2018;71(6):e13-e115. doi:10.1161/HYP.0000000000000065Medline Plus.High blood pressure in pregnancy.United States Preventive Services Task Force.Preeclampsia: screening.American Heart Association.Low-dose aspirin could help pregnant women with high blood pressure avoid a dangerous condition.

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bello NA, Zhou H, Cheetham TC, et al.Prevalence of hypertension among pregnant women when using the 2017 American College of Cardiology/American Heart Association blood pressure guidelines and association with maternal and fetal outcomes.JAMA Netw Open. 2021;4(3):e213808. doi:10.1001/jamanetworkopen.2021.3808Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.Hypertension. 2018;71(6):e13-e115. doi:10.1161/HYP.0000000000000065Medline Plus.High blood pressure in pregnancy.United States Preventive Services Task Force.Preeclampsia: screening.American Heart Association.Low-dose aspirin could help pregnant women with high blood pressure avoid a dangerous condition.

Bello NA, Zhou H, Cheetham TC, et al.Prevalence of hypertension among pregnant women when using the 2017 American College of Cardiology/American Heart Association blood pressure guidelines and association with maternal and fetal outcomes.JAMA Netw Open. 2021;4(3):e213808. doi:10.1001/jamanetworkopen.2021.3808Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.Hypertension. 2018;71(6):e13-e115. doi:10.1161/HYP.0000000000000065Medline Plus.High blood pressure in pregnancy.United States Preventive Services Task Force.Preeclampsia: screening.American Heart Association.Low-dose aspirin could help pregnant women with high blood pressure avoid a dangerous condition.

Whelton PK, Carey RM, Aronow WS, et al.2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines.Hypertension. 2018;71(6):e13-e115. doi:10.1161/HYP.0000000000000065

Medline Plus.High blood pressure in pregnancy.

United States Preventive Services Task Force.Preeclampsia: screening.

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

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Key Takeaways#

Lowering the Threshold#

What This Means For You#

Hypertension in Pregnancy#

Key Takeaways

Lowering the Threshold

What This Means For You

Hypertension in Pregnancy