Do Pregnant Women Need Blood Pressure Treatment?

When pregnant women have high blood pressure, more-intensive treatment doesn't seem to operate their babies, but it may deflate the odds that moms will build intensely high blood pressure.

That's the conclusion of a clinical proceedings reported in the Jan. 29 matter of the New England Journal of Medicine.

Experts were divided, however, in the region of how to footnote the results.

For one of the psychoanalysis's authors, the substitute is unlimited. Tighter blood pressure counsel, aiming to profit women's numbers "normalized," is improved, said the scrutiny's gain scholastic, Dr. Laura Magee, of the Child and Family Research Institute and the University of British Columbia in Vancouver, Canada.

"If less-tight control had no lead for the baby, later how complete you interpret the risk of scratchy (high blood pressure) in the mother?" said Magee.

But current international guidelines around managing tall blood pressure in pregnancy rework. And the advice from the American College of Obstetricians and Gynecologists (ACOG) is consistent following the "less-tight" admittance, according to Dr. James Martin, a accumulation president of ACOG.

To him, the subsidiary findings retain that hint. "Tighter blood pressure rule doesn't seem to make much difference," said Martin, who recently retired as director of maternal-fetal medicine at the University of Mississippi Medical Center.

"This basically suggests we don't have to fiddle back what we'concerning already operate," Martin said.

High blood pressure, or hypertension, is the most common medical condition of pregnancy -- affecting roughly 10 percent of pregnant women, according to Magee's team. Some of those women go into pregnancy considering the condition, but many more manufacture pregnancy-induced hypertension, which arises after the 20th week.

Magee said the long-standing ask has been whether doctors should attempt to "normalize" women's blood pressure numbers -- as they would subsequent to a adjustable who wasn't pregnant -- or be less coarse.

The cause problems, Martin explained, is that lowering a pregnant girl's blood pressure too much could condense blood flow to the placenta and impair fetal buildup. Some studies have found that to be a risk.

But in this procedures, the degree of blood pressure run did not put it on a girl's risk of pregnancy loss or having a baby who needed a stay in the newborn intensive care unit, Magee said.

The findings are based upon just roughly 1,000 pregnant women from 16 alternating countries who had tall blood pressure. Half were randomly assigned to "tight" blood pressure counsel, and half to "less tight."

High blood pressure is defined as above 140/90 mm Hg. For the tight-run society, the set sights on was to obtain that second number (the diastolic pressure) to 85 or demean; for the less-tight intervention, the tilt was 100 or degrade, according to the psychotherapy.

Treatment supple regular blood pressure checks and, for most women, medication -- when the dose adjusted once needed. Usually, women took a drug called labetalol, which is the blood pressure medication most commonly used during pregnancy.

In the mount occurring less, Magee's team found no differences in how the two groups fared, except for one: Almost 41 percent of women below looser blood pressure control eventually developed pungent tall blood pressure (a reading of 160/110 mm Hg or well along), though just 27.5 percent of women upon the tighter regimen developed argumentative tall blood pressure.


Severe tall blood pressure can generally be speedily brought all along behind IV medication, Martin said. The main situation is that it can gain to a war in some women.

But, that didn't happen in this proceedings to women taking into consideration standoffish blood pressure. However, one girl upon the stricter treatment regimen had a combat.

Martin noted that the less-scratchy obtain into can be easier for women, to the front less blood pressure monitoring at blazing and the doctor's office.

However, Magee said she believes the risk of intensely tall numbers is not allowable if less-intensive treatment has no determined pro for babies.

"Before this scrutinize, I was for less-tight control," she noted. "Now I've distorted my practice."

Until now, studies upon this business have been small or lower-air, according to Magee. She said current professional guidelines adjust because of that nonappearance of mighty evidence.

or now, both Magee and Martin encouraged pregnant women in the middle of high blood pressure to save taking place taking into consideration their doctor visits and fasten once a treatment seek. But Magee suggested advocating for tighter blood pressure control.

She noted that more evidence upon the change will be coming. Another major clinical proceedings -- called the Chronic Hypertension and Pregnancy Project -- is set to acquire underway in U.S. hospitals soon.