Deaths Linked to High Blood Pressure in Pregnant Women Are Soaring

By Stephen Renberg, HealthDay Reporter>

The number of American women with chronic hypertension who die during and after pregnancy has risen sharply, a new study warns, Wednesday, January 5, 2022.

Of the 155 million births in the United States between 1979 and 2018, more than 3,200 mothers died of causes related to high blood pressure — a 15-fold increase during this period. The risks were particularly high among black women, according to the study.

“Women need to start well and timely prenatal care during pregnancy, but most importantly, preconception care to diagnose and treat hypertension,” said lead author Kandi Ananth, chair of epidemiology and biostatistics at Rutgers Robert Wood Johnson Medical. Blood before pregnancy is critical.” School in New Brunswick, New Jersey

“Monitoring blood pressure more frequently and monitoring diet and body weight are goals worth considering,” he said.

While maternal death rates from high blood pressure during pregnancy (preeclampsia) have decreased in the United States over the past four decades, death rates from chronic hypertension have increased dramatically — on average, about 9% per year, according to the study. .

“There is also a worrying racial disparity in these unfavorable trends…where black women are at significantly increased and disproportionate risk than white women,” he said. “The study underscores the need to focus on improvements in areas such as maternal ageing, obesity, and racial inequality in access to care.”

About a third of maternal deaths occur before delivery; one third on the day of delivery or within a week; And a third week to a year after birth, according to the study.

Researchers have found that the leading cause of pregnancy-related deaths is cardiovascular disease, including hypertensive disorders.

They estimated that 75% of maternal deaths were preventable.

Notably, those associated with high blood pressure increase with age and were higher among women between 45 and 49. Mortality also increases with obesity.

Among black women, the risk was higher.

The study found that, compared to white women, they had a three to four times higher risk of dying from causes related to blood pressure. The racial disparity has persisted for 40 years, Ananth said.

Although treatment for preeclampsia has improved, chronic high blood pressure is not being treated, he said, probably because many women go undiagnosed. Another factor: The best way to treat high blood pressure in early pregnancy is not clear.

Ananth said that lifestyle changes can make a big difference. This includes quitting smoking, drinking, eating a healthy diet and maintaining a healthy weight before and during pregnancy.

According to the study, about 8 in 10 women with preeclampsia see their blood pressure return to normal after pregnancy. But Ananth said high blood pressure lasts a lifetime by 20%.

Dr. Irene Michus, associate director of preventive cardiology at Johns Hopkins University School of Medicine in Baltimore, reviewed the results.

Doctors are doing a better job of identifying and treating new cases of high blood pressure that develop during pregnancy, she said, but this study shows that they do not do a good job of treating chronic high blood pressure.

“It’s chronic high blood pressure that’s causing the maternal deaths now,” she said. “I think doctors do a better job of paying attention to preeclampsia, but not high blood pressure in younger, pre-pregnant women.”

The good news is that chronic high blood pressure can be prevented, Michos says. The main risk factors are increasing age and obesity — and obesity is preventable, she said.

“But unfortunately, obesity levels are at an all-time high among the US population, with lifestyle factors of an unhealthy diet, low physical activity and sedentary behavior being major factors,” Michus said, adding that psychological stress and social factors such as having a Care is also factors.

“Other data has shown that the cardiovascular health of pregnant women and women of childbearing age in the United States has worsened over time,” she said.

Maternal mortality rates four times higher among black women than white women are “unacceptable,” and the need for public health attention to this gap is urgent, Michos said.

“This racial disparity is likely due to social disparities, lack of access to care, and other disparate treatment that can stem from systemic racism,” she said.

Michos suggested that the best strategy is to improve heart health before pregnancy through weight management and blood pressure checking. She also urged women to “know their numbers” – a normal blood pressure of less than 120/80 mm Hg.

“While we may not treat blood pressure with drug therapy unless it is much higher, everyone benefits from a healthy lifestyle,” she said.

Losing or maintaining weight, intensifying physical activity, decreasing salt intake, increasing consumption of potassium-rich foods and decreasing alcohol use can all help, Michos said.

The new study was recently published in the journal Hypertension.

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