Management of Hypertension during Pregnancy

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Hypertension during Pregnancy

Hypertension, or elevated blood pressure, is generally considered to be present when the systolic pressure is 160 mm Hg or greater and the diastolic pressure is 95 mm Hg. Readings of 140/90 represent borderline hypertension.

Hypertension in Pregnancy

What is Essential Hypertension?

A high blood pressure of unknown cause is known as essential hypertension.

Pre-pregnancy (Essential) Hypertension and its Management

The general measures used to control idiopathic hypertension include the control of stress, attention to diet, regular exercise, and proper rest. The dietary management of patients with idiopathic hypertension has three aspects.

  1. The restriction of sodium in a diet lowers the blood pressure. Patients should be advised to follow a diet that does not contain more than 5 g sodium chloride per day.
  1. Overweight patients should be urged to consume fewer calories. Some patients will improve significantly with a caloric restriction only.
  1. A moderate reduction in cholesterol and saturated fats is recommended as this is likely to reduce the risk of atherosclerosis.
  1. Patients who are smokers should be advised to stop forthwith.

Apart from diet, drugs are the mainstay of the management of hypertension; the patient requires diuretics (like Lasix, etc.) and antihypertensive drugs (e.g., Aldomet, Minipress, Inderal, etc.). If patients' blood pressure is not kept under control it is likely to cause placental dysfunction, premature labour, and the birth of low birthweight babies.

As well as restricting sodium and other precautionary measures, it is important to ensure the proper ratio of energy and nutrients if hypertension is to be controlled. For example, the ratios of protein, carbohydrates, and fat to each other are an important consideration for the person with hypertension. Since these three nutrients contribute calories, they are important to the general management of weight.

  1. Of the three, carbohydrates should have the largest allowance, 50 to 55% of the total calories, with a large portion of complex carbohydrates.
  1. Protein should make up about 15 to 20%.
  1. Fat should be modified to take up only 25 to 30% of the total calories with an emphasis on unsaturated fat.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458675/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925675/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558097/#:~:text=For%20emergency%20treatment%20in%20preeclampsia,recommended%20%5B21%2C%2017%5D.

https://www.tandfonline.com/toc/ihip20/current

https://www.journals.elsevier.com/pregnancy-hypertension

https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-019-2693-9

https://academic.oup.com/jcem/article/84/6/1858/2864369

 



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