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Hypertensive Pregnancy Disorders: From Mechanisms to Management.
Marcus K Robbins1, Hellen Nembaware1, Sautan Mandal1
1Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, United States.
American Journal of Hypertension
|May 8, 2025
Summary
Hypertensive disorders of pregnancy (HDP) impact many pregnancies. This review covers HDP classification, risk factors, pathophysiology, and treatments, emphasizing equitable care for all mothers.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Public Health
Background:
- Hypertensive disorders of pregnancy (HDP) are a major global cause of maternal and perinatal mortality.
- Increasing rates of obesity, chronic hypertension, and advanced maternal age are exacerbating the HDP burden.
- HDP affects up to 10% of pregnancies worldwide.
Purpose of the Study:
- To provide a comprehensive review of hypertensive disorders of pregnancy (HDP).
- To discuss updated classification, risk factors, diagnostics, pathophysiology, and management strategies for HDP.
- To highlight disparities and explore personalized medicine and digital health for equitable HDP care.
Main Methods:
- Comprehensive literature review of hypertensive disorders of pregnancy (HDP).
- Analysis of updated classification systems, risk factors, and diagnostic tools, including biomarkers and imaging.
- Examination of pathophysiological mechanisms, current and emerging therapies, and health disparities.
Main Results:
- HDP pathophysiology involves impaired placentation, angiogenic imbalance, immune dysregulation, oxidative stress, mitochondrial dysfunction, and epigenetic changes.
- Management includes low-dose aspirin, statins, and novel agents; personalized medicine and digital tools show promise.
- Significant racial, ethnic, and socioeconomic disparities exist, disproportionately affecting Black and Indigenous women.
Conclusions:
- A multidisciplinary approach integrating mechanistic insights, public health strategies, and clinical innovation is crucial for reducing HDP burden.
- Addressing disparities is essential for promoting equitable maternal and neonatal outcomes in hypertensive disorders of pregnancy.
- Emerging biomarkers, predictive imaging, and digital health tools offer new avenues for transforming HDP care.
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