Experiencing high blood pressure, or hypertension, during pregnancy can bring unique concerns for you and your baby. Living with a chronic condition like hypertension means that we need to place a major emphasis on prioritizing lifestyle factors to help control our blood pressure. Consider nutrition, exercise, and stress management as integral components of blood pressure management.
**We recommend talking to a dietitian about specific nutrition changes to make a plan to lower blood pressure. Consult your healthcare professional regarding medications and other lifestyle interventions to help control elevated blood pressure.
What is hypertension?
High blood pressure is also known as hypertension. Blood pressure is the force of blood pumping against the arteries and blood vessels. An increased force results in elevated pressure against the arterial walls.
This phenomenon occurs when lifestyle factors impact our cardiovascular system and raise our blood pressure. Hypertension is correlated with sedentary behaviors, a diet high in calories and sodium, the incidence of obesity, and high-stress levels.
During pregnancy, there are unique considerations for hypertension. Sometimes, hypertension in pregnancy cannot be prevented or avoided. However, there are lifestyle changes and medications that can be helpful in the management of hypertension. Hypertension may also increase challenges to conceiving and can have risks for you and the baby after conception.
Hypertension is diagnosed with specific criteria, according to the AHA:
Main types of hypertension during pregnancy
Hypertension in pregnancy likely will fall into one of three categories previously defined. It can range from benign and easily controlled to quite serious with increased medical risks. This makes monitoring blood pressure important to bring awareness and accountability to people’s health risks.
The risks for hypertension in pregnancy include early delivery, decreased oxygen to the placenta, and potential heart disease.
Let’s review the main types of hypertension in pregnancy.
Chronic hypertension is a pre-existing condition known prior to pregnancy. Typically, if you are aware that your blood pressure is elevated before you become pregnant, your doctor will diagnose you with chronic hypertension.
Use the diagnostic criteria above and work with your doctor to determine if you have chronic hypertension prior to getting pregnant.
Gestational hypertension develops during pregnancy. Gestational hypertension is not preventable and generally returns to normal levels postpartum. However, your risk for later developing chronic hypertension is higher if you develop gestational hypertension.
According to Mayo Clinic, gestational hypertension is diagnosed by the following criteria:
- At least 20 weeks gestation
- Blood pressure is greater than 140/90 on at least two occasions
- Must be documented more than four hours apart
- No other organ damage present
Of the three hypertension categories during pregnancy, preeclampsia is the most serious. Preeclampsia specifically develops after 20 weeks of pregnancy and is associated with a sharp spike in blood pressure levels.
Preeclampsia presents with a few notable symptoms:
- sudden fluid swelling
- chronic headaches
- changes in vision
- weight gain.
If you experience any of these symptoms, check in with your doctor right away.
How to manage hypertension during your pregnancy
Managing blood pressure during pregnancy involves a holistic approach. You must consider both your unique lifestyle factors and medical needs. Your doctor may recommend changing your diet and exercise routine or discussing specific medications to help manage your blood pressure.
Physical activity before and during pregnancy can lower your risk for hypertension. One review study found that as little as 30 minutes of physical activity twice a week may lower the incidence of chronic hypertension and gestational hypertension.
Consider moderate-intensity aerobic physical activity to decrease your risk or manage hypertension in pregnancy. Consult with your healthcare team about the appropriate amount of exercise for you.
Nutrition and blood pressure are highly connected. For chronic hypertension, the DASH diet has been the gold standard for nutrition management. This diet is high in fruits, vegetables, and whole grains and generally quite low in sodium and red meats.
Recent research from the American Heart Association shows that the DASH diet may be most beneficial for women who have a high prior risk of developing gestational hypertensive disorders.
Other healthy nutrition behaviors that can help manage blood pressure include eating a variety of fruits and vegetables, drinking enough fluids, and moderating sodium as directed by your healthcare team.
There are some blood pressure medications that are considered safe during pregnancy.
However, ACE inhibitors, renin inhibitors, and angiotensin II receptor blockers are generally contraindicated during pregnancy.
If you have been diagnosed with hypertension during pregnancy, talk with your provider to determine whether or not the medication is right for you.
Lowering Your Risk for Hypertension when Pregnant
There are some inherent risk factors for experiencing hypertension while pregnant.
Firstly, a family history of hypertension or preeclampsia increases your risk as well. Unfortunately, there is nothing we can do about this risk.
Secondly, other chronic conditions like diabetes may put you at an increased risk for elevated blood pressure while pregnant. Your healthcare provider should give you specific blood sugar targets to maintain while pregnant to improve your blood pressure risk as well.
You may not be able to completely prevent hypertension in pregnancy, but you can certainly decrease your risk for complications of hypertension by:
- receiving early perinatal and medical care
- logging your blood pressure at home as advised by your healthcare provider
- managing your blood pressure with a healthy diet and physical activity
Hypertension while pregnant has become more common. . A combination of lifestyle factors and medical intervention are best suited to manage hypertension during gestation. With consistent blood pressure monitoring and good blood pressure control, you and your baby are more likely to stay healthy. If left untreated, the complications of high blood pressure increase health risks to both you and your baby. Work with your medical team to ensure you are engaging in healthy lifestyle factors to manage or prevent hypertension during your perinatal care.
Caroline is a women’s health Registered Dietitian and diabetes educator based in Northern Virginia. In her virtual private practice, she works with women to overcome the chronic yo-yo dieting cycle and find sustainable success with nutrition. You can connect with her via her website www.carolinethomason.com