Hypertension In Women
Issues for Women. Three out of four women with high blood pressure know they have it. Yet fewer than one in three are controlling their blood pressure. All women should take steps to control their blood pressure. Learn more about conditions that can increase blood pressure in women.
Although many pregnant women with high blood pressure have healthy babies without serious problems, high blood pressure can be dangerous for both the mother and the fetus. Women with pre-existing, or chronic, high blood pressure are more likely to have certain complications during pregnancy than those with normal blood pressure. However, some women develop high blood pressure while they are pregnant (often called gestational hypertension).
The effects of high blood pressure range from mild to severe. High blood pressure can harm the mother's kidneys and other organs, and it can cause low birth weight and early delivery. In the most serious cases, the mother develops preeclampsia—or "toxemia of pregnancy"—which can threaten the lives of both the mother and the fetus.
How Can Women with High Blood Pressure Prevent Problems During Pregnancy? If you are thinking about having a baby and you have high blood pressure, talk first to your doctor or nurse. Taking steps to control your blood pressure before and during pregnancy--and getting regular prenatal care--go a long way toward ensuring your well-being and your baby's health.
Before becoming pregnant:
- Be sure your blood pressure is under control. Lifestyle changes such as limiting your salt intake, participating in regular physical activity, and losing weight if you are overweight can be helpful.
- Discuss with your doctor how hypertension might affect you and your baby during pregnancy, and what you can do to prevent or lessen problems.
- If you take medicines for your blood pressure, ask your doctor whether you should change the amount you take or stop taking them during pregnancy. Experts currently recommend avoiding angiotensin-converting enzyme (ACE) inhibitors and Angiotensin II (AII) receptor antagonists during pregnancy; other blood pressure medications may be OK for you to use. Do not, however, stop or change your medicines unless your doctor tells you to do so.
While you are pregnant:
- Obtain regular prenatal medical care.
- Avoid alcohol and tobacco.
- Talk to your doctor about any over-the-counter medications you are taking or are thinking about taking.
Does Hypertension or Preeclampsia During Pregnancy Cause Long-Term Heart and Blood Vessel Problems? The effects of high blood pressure during pregnancy vary depending on the disorder and other factors. According to the National High Blood Pressure Education Program (NHBPEP), preeclampsia does not in general increase a woman's risk for developing chronic hypertension or other heart-related problems. The NHBPEP also reports that in women with normal blood pressure who develop preeclampsia after the 20th week of their first pregnancy, short-term complications--including increased blood pressure--usually go away within about 6 weeks after delivery.
Some women, however, may be more likely to develop high blood pressure or other heart disease later in life. More research is needed to determine the long-term health effects of hypertensive disorders in pregnancy and to develop better methods for identifying, diagnosing, and treating women at risk for these conditions.
Even though high blood pressure and related disorders during pregnancy can be serious, most women with high blood pressure and those who develop preeclampsia have successful pregnancies. Obtaining early and regular prenatal care is the most important thing you can do for you and your baby.
Women taking oral contraceptives experience a small but detectable increase in both systolic and diastolic blood pressure, usually in the normal range. Talk to your doctor about a possible rise in blood pressure and what you can do about it. Women age 35 and older who smoke cigarettes are at even greater risk for heart disease and stroke and are encouraged to quit smoking. If they are unable to quit smoking, they should talk to their doctor about using other forms of contraception.
Hormone Replacement Therapy
A recent study indicated that blood pressure does not increase significantly with hormone replacement therapy in most women with and without high blood pressure. However, a few women may experience a rise in blood pressure attributable to estrogen therapy. Therefore, it is recommended that all women treated with hormone replacement therapy have their blood pressure monitored more frequently after such therapy is started. Your doctor can be very helpful in answering your questions.