Why We Care About Your Blood Pressure—Even Before You Get Pregnant

Having persistently elevated blood pressure prior to becoming pregnant is often referred to as "Chronic Hypertension." It's actually more common than one might think, affecting approximately 2% of all pregnancies. Elevated blood pressure has long been shown to have negative consequences not only for the patient but also for pregnancy outcomes, potentially impacting the baby's health. It's crucial to be aware of these implications and take necessary measures to ensure a healthy pregnancy journey for both the mother and the baby.

In recent years, the American College of Cardiology (ACA) has lowered the threshold for diagnosing high blood pressure, shifting it from 140/90 mmHg to 130/80 mmHg. This adjustment has significant implications, especially for women of reproductive age, as it means that more individuals will receive a high blood pressure diagnosis prior to conceiving. This change represents a positive development as it enables early detection and intervention, ensuring that women receive the necessary support and care to maintain their health and promote a successful pregnancy.

What Does This Mean For You When You're Trying To Conceive?

It signifies the importance of prioritizing your overall health and ensuring that you undergo evaluations for high or "borderline" blood pressure readings. I refer my patients to their Primary Care Doctor and recommend they have an informed discussion with them about their timeline for their family building plans, particularly if medication is required. Some medications may not be recommended during pregnancy, so it's essential to explore alternatives and make informed decisions in consultation with your healthcare provider. By addressing any potential high blood pressure concerns and making appropriate adjustments, you can optimize your health and increase the chances of a successful pregnancy journey.

Is Medication The Only Way To Control Blood Pressure?

Short answer: No! Here are other ways to help control your blood pressure:

• Lose Weight—Weight loss can be incredibly beneficial in reducing your blood pressure, and it doesn't always necessitate a substantial amount of weight loss. Even losing just 2 pounds can have a positive impact, potentially lowering your blood pressure by 2-5 mmHg. It's important to remember that every little step counts when it comes to improving your health. By making gradual and sustainable changes to your lifestyle, such as incorporating regular physical activity and adopting a healthy diet, you can achieve weight loss and contribute to better blood pressure management.
• Review What You Eat—Making dietary changes can also play a significant role in lowering blood pressure. Switching to a low-fat diet that includes a generous amount of fruits and vegetables has been shown to be beneficial. Additionally, transitioning to a low-sodium diet, with an intake ranging between 1000-1500 mg/day, can further aid in reducing blood pressure. It's important to be mindful of sodium content in foods and opt for healthier, low-sodium alternatives. Moreover, reducing alcohol intake can be a key factor in managing blood pressure effectively. By incorporating these dietary adjustments, you can actively support your efforts to maintain healthy blood pressure levels and overall well-being.
• Get Moving—Getting active and incorporating regular exercise into your routine is crucial for managing blood pressure. While different forms of exercise can be beneficial, the goal is to aim for 90-150 minutes per week of aerobic or resistance exercise. This can include activities such as brisk walking, jogging, cycling, swimming, or engaging in strength training exercises. By consistently engaging in physical activity, you can improve cardiovascular health, strengthen your body, and contribute to the overall management of blood pressure. Remember to consult with your healthcare provider before starting any new exercise program and find activities that you enjoy to make it easier to stick with your fitness goals.

What Are The Risks During Pregnancy If I Have Chronic Hypertension?

Patients with chronic hypertension have an increased risk of pregnancy complications, including preeclampsia, stroke, heart issues (both during and after delivery), as well as preterm birth and growth restriction. However, these risks can be minimized through appropriate monitoring and ensuring well-controlled blood pressure before and during pregnancy. 

The Bottom Line

When trying to conceive, it's essential to prioritize comprehensive health care. If diagnosed with elevated blood pressure, it may be recommended to temporarily pause treatment for a month or so until further evaluation. Taking this break allows for a thorough assessment of the condition. While it may require patience, the long-term benefits of ensuring a well-managed blood pressure will likely contribute to the healthiest outcomes for both you and your future baby. Remember to consult with your healthcare provider to discuss the best course of action tailored to your specific situation. 

Even if you (or your partner) are not planning on carrying the pregnancy or are ready to conceive, taking notice of your own blood pressure and overall health is important. Much like fertility preservation is a way to optimize your reproductive health and outcomes, evaluating your overall health, treatment blood pressure issues with diet, lifestyle modifications and early intervention (if indicated) are key ways to optimize your health and allow for a longer, healthier lifespan.

Author

Dr. Nidhee Sachdev Nidhee Sachdev, MD has trained among the most prestigious and diverse medical programs in the country, including fellowship training in reproductive endocrinology and infertility at the prestigious New York University (NYU) Langone Fertility Center in New York City where she conducted research on preimplantation genetic screening (PGS) and the University of Chicago Medical Center, where she earned the academic distinction of chief resident in obstetrics and gynecology, and trained under a top recurrent pregnancy loss expert. Dr. Sachdev is passionate about providing individualized, collaborative patient care. She started her medical career right here in Orange County, earning her Doctor of Medicine at the University of California, Irvine, School of Medicine.