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Hypertension in Pregnancy: A Diagnostic and Therapeutic Overview.

Authors :
Cífková R
Source :
High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension [High Blood Press Cardiovasc Prev] 2023 Jul; Vol. 30 (4), pp. 289-303. Date of Electronic Publication: 2023 Jun 13.
Publication Year :
2023

Abstract

Hypertensive disorders in pregnancy are associated with increased risk of maternal, fetal, and neonatal morbidity and mortality. It is important to distinguish between pre-existing (chronic) hypertension and gestational hypertension, developing after 20 weeks of gestation and usually resolving within 6 weeks postpartum. There is a consensus that systolic blood pressure ≥ 170 or diastolic blood pressure ≥ 110 mmHg is an emergency and hospitalization is indicated. The selection of the antihypertensive drug and its route of administration depend on the expected time of delivery. The current European guidelines recommend initiating drug treatment in pregnant women with persistent elevation of blood pressure ≥ 150/95 mmHg and at values > 140/90 mmHg in women with gestational hypertension (with or without proteinuria), with pre-existing hypertension with the superimposition of gestational hypertension, and with hypertension with subclinical organ damage or symptoms at any time during pregnancy. Methyldopa, labetalol, and calcium antagonists (the most data are available for nifedipine) are the drugs of choice. The results of the CHIPS and CHAP studies are likely to reduce the threshold for initiating treatment. Women with a history of hypertensive disorders in pregnancy, particularly those with pre-eclampsia, are at high risk of developing cardiovascular disease later in life. Obstetric history should become a part of the cardiovascular risk assessment in women.<br /> (© 2023. The Author(s).)

Details

Language :
English
ISSN :
1179-1985
Volume :
30
Issue :
4
Database :
MEDLINE
Journal :
High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension
Publication Type :
Academic Journal
Accession number :
37308715
Full Text :
https://doi.org/10.1007/s40292-023-00582-5