Lets talk about high blood pressure, also known as Hypertension. We are increasingly diagnosing hypertension in the western world and now most people recognize that it is one of the leading risk factors for heart disease and stroke.
Hypertension occurs as a result of an increased force of blood ejected from the heart, which puts pressure on the walls of blood vessels. A value greater than or equal to 140/90 mmHg is the cut off in this country for investigating and treating hypertension.
If you’ve been found to have a reading of this or higher by your doctor, you will be encouraged to have 24 hour blood pressure monitoring to establish how high your blood pressure is. Following this, treatment may be started. The mainstay of treatment is antihypertensives (medication). I won’t talk about the different types of medications there are that are able to treat high blood pressure as this would be another post in itself and very veryboring to most people!
If you have been told you have high blood pressure and you don’t have a family history of this, there are some conditions that could cause high blood pressure and should be considered by your doctor. These conditions may involve your kidneys, heart or endocrine system.
Once these have been ruled out, you are then diagnosed with Essential Hypertension, meaning no other cause has been found.
What factors affect blood pressure?
I am only qualified to discuss the proven lifestyle and medical measures that help target high blood pressure. I will not delve into complementary medicine or alternative therapies as I just don’ t know much about these types of treatments.
Lifestyle modifications are quick and easy and can make a difference to your blood pressure. A diet low in salt will reduce blood pressure along with regular aerobic exercise.
Stress can also increase your blood pressure along with causing a number of other symptoms; so generally leading a stress-free life would be better for your overall health (easier said than done!!!).
Hypertension in Pregnancy or Gestational Hypertension
This can be a serious condition and is often managed by two disciplines; the cardiologists and the obstetricians.
If you already suffer from hypertension before conceiving, it may be worthwhile discussing your treatment with your doctor before you get pregnant because 2 particular classes of medications can cause congenital abnormality. It is advised that these should be stopped as soon as you know you are pregnant or ideally before you conceive if you are planning a family. During your pregnancy, you will be followed closely to ensure you don’t develop Pre-Eclampsia (a complication of Gestational Hypertension)which may put you or your baby at risk.
If you do not suffer from hypertension generally, it may be picked up during your antenatal check and you will then be referred to the Obstetrician for close monitoring. All the same issues may occur with someone who already has long standing hypertension.
Following this, if you are deemed high risk for developing pre-eclampsia, you will be taking Aspirin from week 12 until you deliver your baby. These risk factors include hypertension during a previous pregnancy, already known hypertension, diabetes, kidney disease or an autoimmune condition. Other more ‘softer’ risk factors are older age (over 40 years), a high BMI, family history of pre-eclampsia or multiple pregnancies.
Symptoms of Pre-Eclampsia
Pre-Eclampsia is a condition that may occur as a result of Gestational Hypertension and is characterized by a number of symptoms. These can be non specific so if you have any of these and have gestational hypertension, you must contact your obstetric team.
Reduced urine output
Nausea or vomiting
If you are diagnosed with pre-eclampsia, the trouble then becomes when to safely deliver your baby as it may become urgent to do so. It may be necessary to induce you and deliver the baby (even if the baby may be pre term) in order to save you and your baby.
The complications of pre-eclampsia include fetal growth impairment, premature birth, placental abruption and damage to other organs including your liver (this is life threatening) and also Eclampsia, which is characterized by seizures. This may lead to brain injury.
Things can get dangerous for you and your baby pretty quickly when it gets to this point. The challenge for doctors is to safely deliver your baby and minimize any risks.
Following delivery, there is a small risk that you may develop hypertension later on in your life or develop gestational hypertension during subsequent pregnancies.
By writing this post, I wanted to highlight that something as little as managing high blood pressure can easily turn into a fatality in pregnancy and so it is worth spreading awareness surrounding gestational hypertension.
That’s it for me for now, I wish you all safe pregnancies and healthy babies!