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While you may think of high blood pressure as a problem for your parents or grandparents, many pregnant women experience blood-vessel problems that force the heart to work harder to pump blood to the placenta and maternal organs. In fact, up to 30 percent of first-time pregnancies are affected by hypertension, preeclampsia (high blood pressure plus protein in the urine) or eclampsia (high blood pressure, protein in the urine and seizures). A majority of women with hypertensive disorders will deliver healthy babies and fully recover, but you and your baby’s present—and future—heart health may be at risk.
Why some women develop hypertensive disorder during pregnancy is not entirely known, but it’s more likely among women who are pregnant for the first time, are obese, are 35 years or older, have a history of medical conditions, are carrying twins or are African-American. Often women experience no symptoms, though preeclampsia in extreme cases can damage a woman’s kidneys, brain and other organs. More commonly, these disorders prevent the fetus from growing appropriately. And because the only “cure” for preeclampsia is delivery, this disorder is one of the most common known causes of prematurity, responsible for as many as 100,000 of the total 500,000 premature births each year, according to the Preeclampsia Foundation.
Regular physical activity during pregnancy appears to reduce a woman’s risk of developing hypertension and preeclampsia, human and animal studies suggest. “Maintain your weight and exercise three to five days a week,” advises Lori Mosca, M.D., director of preventative cardiology at New York Presbyterian Hospital. Also, be alert to symptoms of preeclampsia, including headaches, vision problems, rapid weight gain and swelling of the hands and face.
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Those women who are being treated for hypertension during pregnancy also need to be aware of the potential for danger. A recent study of Medicaid data from more than 1.1 million pregnant women found that nearly 5 percent receive blood pressure medications. The problem is that there’s limited information about the safety and effectiveness of such blood pressure drugs during pregnancy. In fact, common medications, such as ACE inhibitors and angiotensin receptor blockers, can cause poor growth, kidney problems and even death in fetuses, researchers report.
If you are taking any of these medications and are or plan to become pregnant, talk to your doctor about safer alternatives, says Mosca. In general, methyldopa and labetalol are the recommended blood-pressure medications for use during pregnancy.
For the first time, the guidelines from the American Heart Association (AHA) on the prevention of cardiovascular disease in women in 2011 named pregnancy complications as risk factors. Newer research suggests that moms-to-be who have hypertension, preeclampsia or gestational diabetes, a disorder characterized by high blood-glucose levels during pregnancy, are twice as likely to develop heart disease in the future.
In addition to exercise and weight control, women should see a primary care doctor or cardiologist postpartum to ensure careful monitoring and control of risk factors, state the AHA guidelines. Also, it’s important to mention your pregnancy complications the first time you see a new doctor.
Even if you had a hypertension or preeclampsia scare during pregnancy, it’s easy to forget once your baby is born. Says Mosca, “One of the greatest gifts we can give our children is to role-model the importance of a heart-healthy lifestyle.”