What Is Hypertension?
Hypertension is also known as high blood pressure. Healthcare professionals will use the following measures to determine your blood pressure:
- The systolic blood pressure (the “top number”) measures when the heart contracts.
- The diastolic blood pressure (the “bottom number”) measures when the heart relaxes.
Blood pressure is represented by the systolic number over the diastolic number. High blood pressure can be diagnosed if either the systolic or diastolic blood pressure is elevated.
Your blood pressure is considered normal if it is 120/80, or somewhere close to that ratio. If it goes higher than that, you might have high blood pressure.
Prolonged high blood pressure puts us at risk for aneurysm, stroke, cardiac arrest, or even kidney failure. Sudden trauma, physiological stress, or other events can cause a quick spike in blood pressure, but the typical path to hypertension is gradual over months and years.
Without regular monitoring, high blood pressure frequently goes undetected, and many patients are without symptoms. However, chest pains, dizziness, shortness of breath, and headache can signal hypertension in advanced stages. Therefore, periodic checks from a healthcare provider are essential – these visits can prevent a mild condition from becoming an emergent situation.
Chronic hypertension – Chronic hypertension is defined as hypertension before pregnancy, whether or not the woman was on medication. Chronic hypertension is also suspected in women who have high blood pressure before the 20th week of pregnancy, although the diagnosis can only be confirmed once the pregnancy is over.
Can I get pregnant and have a normal pregnancy if I have hypertension?
Women who have controlled, chronic hypertension can achieve pregnancy, and many go on to have a normal pregnancy. Before you try to get pregnant, talk with your doctor. If you are taking blood pressure medicine, it is important to check and see if it is safe to take while attempting to get pregnant and safe to continue during pregnancy. If your blood pressure is well-controlled, you are more likely to have positive health outcomes during pregnancy, labor, and after delivery. Women with chronic hypertension are at an increased risk of developing problems in pregnancy that can pose a risk for both the mother and the baby.
Hypertension in Pregnancy
There are four major types of hypertension (high blood pressure) during pregnancy:
- Chronic hypertension – Chronic hypertension is defined as hypertension before pregnancy, whether or not the woman was on medication. Chronic hypertension should also be suspected in women who have hypertension before the 20th week of pregnancy, although the diagnosis can only be confirmed once the pregnancy is over.
- Gestational hypertension (also called transient hypertension) – A diagnosis of gestational hypertension should be made in a woman who develops hypertension for the first time in pregnancy after 20 weeks of gestation and who has no other symptoms or signs of preeclampsia, such as protein in the urine (proteinuria). Over time, some women with gestational hypertension will develop proteinuria or other signs of preeclampsia and be considered to have preeclampsia, while others will be diagnosed with chronic hypertension because of persistently high blood pressure three months after delivery.
- Preeclampsia – Preeclampsia refers to the new onset of hypertension and evidence of organ injury in a pregnant woman during the latter half of gestation (after 20 weeks of pregnancy). Many organs can be affected, including the kidneys (leading to excess protein in the urine, called proteinuria), the liver, and the brain (leading to headaches and changes in vision, and occasionally seizures). Preeclampsia can occur for the first time after delivery. The organ injury typically resolves within several days to weeks after delivery.
- Preeclampsia superimposed upon chronic hypertension – This term describes a woman with chronic hypertension who then develops preeclampsia after the 20th week of pregnancy.
What are the risks for pregnant women with hypertension?
Women with any form of hypertension in pregnancy are at higher risk for developing preeclampsia and at greater risk for the following problems:
- Placental abruption – The placenta is the organ inside the uterus that brings the baby nutrients and oxygen and carries away waste. It is attached to the inside wall of the uterus. Placental abruption is when part or all the placenta separates from the uterus before the baby is born. If this happens, the baby might not get enough nutrients and oxygen.
- Slowed growth of the baby – The baby can be small and not grow normally.
Because of the increased risks for both the mother and baby, women with all types of hypertension require specialized care during pregnancy. Contact Northside/Northpoint OB-GYN for specialized, state-of-the-art treatment during your pregnancy by our highly trained, experienced, and informed physicians and providers.