Chronic High Blood Pressure During Pregnancy: What You Need to Know

Pregnancy is an exciting time, but if you have chronic high blood pressure (hypertension), you may have extra concerns about your health and your baby’s well-being. Managing high blood pressure during pregnancy is crucial to preventing complications like preeclampsia, preterm birth, or low birth weight. The good news? With the right care and lifestyle changes, you can have a healthy pregnancy and a healthy baby. This guide will walk you through everything you need to know about chronic hypertension during pregnancy, including risks, treatments, and tips for staying healthy.

What Is Chronic Hypertension?

Chronic hypertension means high blood pressure (above 140/90 mmHg) that started before pregnancy or before 20 weeks of pregnancy. It is different from gestational hypertension, which develops after 20 weeks and usually goes away after delivery.

Types of High Blood Pressure in Pregnancy

There are three main types of hypertension during pregnancy:

1. Chronic Hypertension – High blood pressure that existed before pregnancy or is diagnosed before 20 weeks.
2. Gestational Hypertension – High blood pressure that starts after 20 weeks but without other complications.
3. Preeclampsia – A serious condition where high blood pressure leads to organ damage, usually after 20 weeks.

If you have chronic hypertension, your doctor will closely monitor your pregnancy to prevent complications.

Risks of High Blood Pressure in Pregnancy

Uncontrolled hypertension can increase the risk of:

• Preeclampsia – A dangerous condition that can affect the liver, kidneys, and placenta.
• Preterm Birth – Babies may be born too early if hypertension causes complications.
• Low Birth Weight – Reduced blood flow can affect your baby’s growth.
• Placental Abruption – A serious condition where the placenta detaches from the uterus too early.

While these risks sound scary, proper treatment and monitoring can help you have a safe pregnancy.

Managing Chronic Hypertension During Pregnancy

1. Regular Prenatal Checkups

Your doctor will closely monitor your blood pressure and may recommend:
More frequent prenatal visits
Growth ultrasounds to check your baby’s development
Non-stress tests to monitor your baby’s heart rate

2. Medications: Are Blood Pressure Drugs Safe?

Some blood pressure medications are safe during pregnancy, while others should be avoided. Safe Medications:

• Labetalol – A common first-choice medication
• Methyldopa – Often used in pregnancy
• Nifedipine (Procardia) – A calcium channel blocker

Avoid These Medications:

• ACE inhibitors (Lisinopril, Enalapril) – Can harm the baby’s kidneys
• ARBs (Losartan, Valsartan) – Not safe for pregnancy
• Diuretics – May reduce blood flow to the placenta

Always talk to your doctor before stopping or changing any medications.

3. Healthy Diet Choices

Eating a balanced diet can help manage blood pressure. Try to:
Eat plenty of fruits, vegetables, and whole grains
Limit salt and processed foods
Choose lean proteins like chicken, fish, and beans
Stay hydrated and drink plenty of water

4. Exercise Safely

Staying active can help keep your blood pressure in check. Safe pregnancy exercises include:
Walking
Prenatal yoga
Swimming Avoid heavy lifting or high-impact workouts. Always check with your doctor before starting a new exercise routine.

5. Monitor Your Blood Pressure at Home

Using a home blood pressure monitor can help you track your levels and alert your doctor if something changes.

• Ideal pregnancy blood pressure: Below 140/90 mmHg
• When to call your doctor: If blood pressure is consistently higher than 160/110 mmHg

Signs of Preeclampsia: When to Seek Help

Even if you manage chronic hypertension well, preeclampsia can still develop. Call your doctor immediately if you experience: Severe headaches that won’t go away
Vision changes (blurry vision, flashing lights)
Sudden swelling in your face, hands, or feet
Shortness of breath or chest pain
Upper right abdominal pain
A sudden spike in blood pressure Preeclampsia is serious and requires urgent medical care.

Will I Need to Deliver Early?

Doctors aim for a full-term delivery (around 37-39 weeks), but if your blood pressure is too high, they may recommend early induction or a C-section. If preeclampsia develops, delivery may be needed earlier to protect you and your baby.

Final Thoughts: You Can Have a Healthy Pregnancy!

Chronic high blood pressure can make pregnancy more complicated, but with the right care, most women go on to have healthy babies. The key is:
Work closely with your doctor
Take prescribed medications if needed
Eat a balanced diet and stay active
Monitor your blood pressure regularly By taking these steps, you can manage hypertension and look forward to a safe, healthy delivery. You've got this, mama!