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Chronic Hypertension in Pregnancy: A Lens Into Cardiovascular Disease Risk and Prevention.
Natalie A Cameron1, Ian K Everitt2, Kristen A Lee3
1Department of Medicine, Division of General Internal Medicine (N.A.C.), Northwestern University Feinberg School of Medicine.
Hypertension (Dallas, Tex. : 1979)
|March 24, 2023
Summary
Chronic hypertension in pregnancy (CHTN) is rising, particularly among certain racial and geographic groups, increasing risks for mothers and infants. Early detection and intervention during pregnancy can mitigate long-term cardiovascular disease risks.
Area of Science:
- Public Health
- Cardiovascular Medicine
- Maternal-Fetal Medicine
Background:
- Hypertension is a significant, modifiable risk factor for cardiovascular disease (CVD).
- The prevalence of chronic hypertension (CHTN) during pregnancy has nearly doubled in the U.S. over the last decade.
- Disparities based on race and location persist in CHTN prevalence.
Purpose of the Study:
- To review the epidemiology, diagnosis, and management guidelines for CHTN in pregnancy.
- To examine the association between CHTN, adverse pregnancy outcomes, and long-term CVD risk.
- To identify opportunities within peripartum care to reduce hypertension and CVD risk equitably.
Main Methods:
- Literature review summarizing current evidence on CHTN in pregnancy.
- Analysis of epidemiological data on CHTN prevalence and disparities.
- Synthesis of guidelines for diagnosis and management.
- Review of studies on CHTN's impact on maternal, fetal, and long-term cardiovascular health.
Main Results:
- Elevated blood pressure during pregnancy increases risks for maternal and fetal morbidity and mortality.
- CHTN during pregnancy is linked to a higher lifetime risk of CVD in birthing individuals.
- Persistent race- and place-based disparities exist in CHTN prevalence and outcomes.
Conclusions:
- Identifying and managing CHTN during pregnancy is crucial for mitigating immediate and lifelong cardiovascular risks.
- Peripartum care presents a critical window for interventions to promote cardiovascular health.
- Equitable health services and public health strategies are needed to address disparities and reduce hypertension and CVD risk.
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