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High Blood Pressure

Pregnancy and high blood pressure

06/07/2007

Question:

I already have high blood pressure usualy around 130/80 with the use of two medications. How might pregnancy effect my blood pressure?

Answer:

The blood pressure usually drops during the first half of pregnancy, but this is not always the case in women who are hypertensive prior to pregnancy.  Hypertension increases the risk of complications to the mother and the fetus, but most hypertensive women can have normal pregnancies and deliveries.

Women with mild to moderate hypertension should be followed closely by an obstetrician during pregnancy.  They should not exercise intensively, not smoke or drink alcohol, and restrict salt intake to about 5 gm per day.

Some antihypertensive medications are contraindicated in pregnancy.  Especially ACE inhibitors, angiotensin receptor blockers and renin inhibitors must be stopped as soon and pregnancy is detected (and preferably before).  The preferred drugs for treatment of hypertension during pregnancy are methyldopa, labetalol and calcium channel blockers.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati