Treating high blood pressure during pregnancy is safe for the baby, reduces mother's lifelong risks
High blood pressure during pregnancy can cause serious health problems for both the mother and the baby. It raises the risk of early delivery, low birthweight and long-term heart issues for the mother.
Studies have shown that women who have high blood pressure, also called hypertension, before they become pregnant may be twice as likely as those who don't to develop cardiovascular disease within a decade of giving birth. And if their pregnancies involve complications, they can be up to 10 times more likely to have premature cardiovascular problems.
The American Heart Association considers a systolic (top) reading of at least 130 mmHg or a diastolic (bottom) reading of at least 80 mmHg high blood pressure. According to the American College of Gynecologists and Obstetricians, blood pressure readings of 140 mm Hg systolic and/or 90 mm Hg diastolic or higher, measured twice, at least four hours apart, after 20 weeks of pregnancy is high blood pressure, also called gestational hypertension. If other organs are also affected, it is called preeclampsia.
A 2023 study, published by the Journal of the American Heart Association, looked at blood pressure control in women of childbearing age with high blood pressure, focusing on racial and ethnic differences.
The study found Black women were more likely to have uncontrolled blood pressure than their white counterparts, and food insecurity was more common among Black and Hispanic women, highlighting racial inequities that likely contribute to higher maternal mortality rates in under-resourced communities. American Indian and Alaska Native women also face major health disparities, according to the Centers for Disease Control and Prevention’s (CDC) “Hear Her Campaign”, with higher rates of pregnancy-related deaths and other health problems linked to past trauma, such as colonization and forced migration.
Experts say getting care from skilled health care professionals before, during, and after childbirth can help save the lives of both women and newborns.
"Given the rising number of cases of hypertension during pregnancy, together with hypertension-related complications, the problem has become a public health crisis, particularly among women from racially and ethnically diverse backgrounds," said Dr. Vesna D. Garovic, a professor of medicine at Mayo Clinic in Rochester, Minnesota.
But for decades, Garovic said, the benefits of blood pressure treatment for pregnant women were unclear. "And there were concerns about fetal well-being from exposure to antihypertensive medications."
So, Garovic led a committee of pregnancy care, heart and kidney health and internal medicine experts in analyzing, researching and publishing a 2021 scientific statement in the American Heart Association’s journal Hypertension, which showed that treatment may actually reduce a pregnant woman's risk for severe high blood pressure without endangering the child.
According to the report, treating blood pressure with medication during pregnancy doesn’t seem to harm the baby’s development. Keeping blood pressure under control also helps protect the mother’s health — both during pregnancy and afterward. Women with high blood pressure during pregnancy are also more likely to have long-term high blood pressure later in life compared to those with normal blood pressure.
Garovic called for more research to pinpoint the best time to start treating high blood pressure during pregnancy. Still, she said she found it reassuring that recent studies show it’s safe and effective to treat high blood pressure during pregnancy — and that it might help even at lower levels than experts used to think.
The 2021 statement also called for increased efforts in reducing severe high blood pressure in communities that lack resources and expertise to respond to hypertension emergencies. It also reinforced research that suggests lifestyle changes before and during pregnancy can improve maternal and fetal outcomes.
Clearly, it’s more important than ever to raise awareness, expand access to care and support research on high blood pressure during pregnancy. And the growing evidence that treatment is both safe and effective offers real hope for improving outcomes — not just during pregnancy, but for lifelong heart health.
