Friday, 30 January 2015

Do Pregnant Women Need High Blood Pressure Treatment?


Controlling blood pressure doesn't seem to affect baby, but may prevent problems for mom

WebMD News from HealthDay

By Amy Norton

HealthDay Reporter

WEDNESDAY, Jan. 28, 2015 (HealthDay News) -- When pregnant women have high blood pressure, more-intensive treatment doesn't seem to affect their babies, but it may lower the odds that moms will develop severely high blood pressure.

That's the conclusion of a clinical trial reported in the Jan. 29 issue of the New England Journal of Medicine.

Experts were divided, however, on how to interpret the results.

For one of the study's authors, the choice is clear. Tighter blood pressure control, aiming to get women's numbers "normalized," is better, said the study's lead researcher, Dr. Laura Magee, of the Child and Family Research Institute and the University of British Columbia in Vancouver, Canada.

"If less-tight control had no benefit for the baby, then how do you justify the risk of severe (high blood pressure) in the mother?" said Magee.

But current international guidelines on managing high blood pressure in pregnancy vary. And the advice from the American College of Obstetricians and Gynecologists (ACOG) is consistent with the "less-tight" approach, according to Dr. James Martin, a past president of ACOG.

To him, the new findings support that guidance. "Tighter blood pressure control doesn't seem to make much difference," said Martin, who recently retired as director of maternal-fetal medicine at the University of Mississippi Medical Center.

"This basically suggests we don't have to change what we're already doing," Martin said.

High blood pressure, or hypertension, is the most common medical condition of pregnancy -- affecting about 10 percent of pregnant women, according to Magee's team. Some of those women go into pregnancy with the condition, but many more develop pregnancy-induced hypertension, which arises after the 20th week.

Magee said the long-standing question has been whether doctors should try to "normalize" women's blood pressure numbers -- as they would with a patient who wasn't pregnant -- or be less aggressive.

The worry, Martin explained, is that lowering a pregnant woman's blood pressure too much could reduce blood flow to the placenta and impair fetal growth. Some studies have found that to be a risk.

source : Do Pregnant Women Need High Blood Pressure Treatment?

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