Cardiovasc Prev Pharmacother.  2022 Jul;4(3):99-105. 10.36011/cpp.2022.4.e16.

Blood pressure control in hypertensive disorders of pregnancy

• Rismiati H
• Lee HY

• KMID: 2532275
• DOI: http://doi.org/10.36011/cpp.2022.4.e16

Abstract

Hypertension is a major cause of maternal morbidity and occurs as a complication in up to one in ten pregnancies. Hypertensive disorders of pregnancy encompass gestational hypertension, preeclampsia, chronic hypertension, and chronic hypertension with superimposed preeclampsia. However, the management of hypertensive disorders of pregnancy remains a matter of debate, particularly the blood pressure thresholds and targets for managing hypertension in pregnancy. Previously, there was no clear evidence of the effectiveness of aggressive blood pressure control in pregnancy due to the risk of fetal growth restriction. Recent clinical trials have shown that aggressive control of blood pressure in pregnant women is safe for both the mother and fetus. The purpose of this paper is to present a clinically oriented guide to the drugs of choice in patients with hypertension during pregnancy, present contrasts among different guidelines and recent clinical trials, and discuss the blood pressure thresholds and targets for hypertension during pregnancy based on recent studies.

Keyword

Pregnancy; Hypertension; Blood pressure

Figure

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  Fig. 1. Odds ratios for maternal complications according to the subtype of hypertension in pregnancy.

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  Fig. 2. Hypertensive disorders of pregnancy: blood pressure thresholds and targets. NICE, National Institute for Health and Care Excellence; ESC/ESH, European Society of Cardiology/European Society of Hypertension; ISSHP, International Society for the Study of Hypertension in Pregnancy; ACOG, American College of Obstetricians and Gynecologists; KSH, Korean Society of Hypertension; DBP, diastolic blood pressure.

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