World Hypertension Day: What Causes High Blood Pressure in Pregnancy (Preeclampsia)? Who Is At Risk?

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Every year on 17 May, World Hypertension Day serves as a global reminder that high blood pressure (hypertension) is not just a number on your medical chart-it's a silent, persistent threat to your heart, brain, and overall health. Organized by the World Hypertension League (WHL), this day focuses on raising awareness about hypertension, encouraging early detection, promoting prevention strategies, and ultimately reducing the risk of heart disease and stroke worldwide.

According to a World Health Organisation (WHO) report, an estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries. The same report states that about 46% of adults with hypertension are unaware that they have the condition.

Also, hypertension carries unique and serious risks during pregnancy, a time when a person's body's health directly impacts two lives.
For expectant mothers, managing blood pressure isn't just about their well-being; it's also about protecting the life developing inside them. From increased risks of preeclampsia to premature birth and long-term health concerns for both mother and baby, high blood pressure in pregnancy deserves greater awareness.

Let us know how hypertension can affect pregnancy and why early detection and management are vital.

What Is Preeclampsia?

Preeclampsia is a pregnancy-related complication that typically occurs after the 20th week of gestation. It is characterized by high blood pressure (140/90 mm Hg or above) and often includes protein in the urine or damage to organs such as the liver or kidneys. Preeclampsia can range from mild to severe and, if untreated, may lead to serious complications for both the mother and baby, including a potentially life-threatening condition called eclampsia. While it primarily occurs during pregnancy, it can also develop postpartum.

What Causes It?

The exact cause of preeclampsia remains uncertain, but researchers believe it begins in the placenta. In a healthy pregnancy, blood vessels develop to efficiently supply blood to the placenta. In women with preeclampsia, these vessels may not form or function properly, leading to restricted blood flow. This disruption may cause the placenta to release substances into the mother's bloodstream that affect blood vessel function and result in high blood pressure and organ stress.

Recognizing The Symptoms

Preeclampsia can develop silently, especially in its early stages, which is why regular prenatal check-ups are critical. However, some common symptoms include persistent headaches, swelling in the hands, face, or feet, sudden weight gain, vision changes (blurriness, flashing lights, or seeing spots), and pain in the upper right abdomen. Some women may also experience shortness of breath or nausea. Not all swelling or discomfort is cause for concern during pregnancy, but sudden or severe symptoms should never be ignored.

Who Is At Risk?

Any pregnant woman can develop preeclampsia, but certain factors increase the risk. These include:

• First-time pregnancy
• History of preeclampsia in a previous pregnancy
• Multiple pregnancies (twins, triplets)
• Chronic high blood pressure
• Diabetes or kidney disease
• Obesity or a BMI over 30
• Age over 35
• Family history of preeclampsia
• Autoimmune conditions like lupus or antiphospholipid syndrome

How It's Diagnosed

Diagnosis of preeclampsia involves monitoring blood pressure and checking for protein in the urine, typically through a urine sample. Blood tests may be performed to assess liver enzymes, kidney function, and platelet levels. Imaging, such as ultrasounds or fetal non-stress tests, may also be used to evaluate the baby's growth and well-being. Regular prenatal visits play a key role in early detection, even before noticeable symptoms appear.

Treatment And Management Options

There is no definitive cure for preeclampsia other than delivering the baby. If the condition is diagnosed close to full term (37 weeks or later), doctors may recommend induction of labor or a cesarean section. For earlier pregnancies, treatment focuses on managing symptoms to prolong the pregnancy safely. This may include blood pressure medications, corticosteroids to help fetal lung development, and magnesium sulfate to prevent seizures. Hospitalization may be required in more severe cases for continuous monitoring.

Potential Complications

If left untreated, preeclampsia can progress to eclampsia, a condition marked by seizures that can endanger both mother and baby. It may also lead to HELLP syndrome (a severe form involving liver damage and low platelets), placental abruption (where the placenta detaches from the uterus), preterm birth, and fetal growth restriction. Timely intervention greatly reduces the risk of these complications, reinforcing the importance of early diagnosis and continuous prenatal care.

Prevention And Risk Reduction

While preeclampsia cannot always be prevented, certain steps may help reduce the risk. Maintaining a healthy lifestyle before and during pregnancy is key-this includes regular exercise, a balanced diet, and managing pre-existing health conditions. In some high-risk pregnancies, doctors may recommend a daily low-dose aspirin starting in the second trimester. Monitoring your blood pressure at home and keeping all prenatal appointments are also essential parts of a preventive strategy.

Preeclampsia often resolves after delivery, but the recovery process can take days or weeks. Some women may continue to experience high blood pressure postpartum, which requires monitoring and treatment. It's also important to know that having preeclampsia increases the risk of developing cardiovascular disease later in life. Your doctor may recommend lifestyle changes and regular screenings even after pregnancy to protect your long-term health.

When To Call Your Doctor

If you're pregnant and experience any warning signs-such as intense headaches, blurred vision, sudden swelling, or abdominal pain-call your healthcare provider immediately. Even subtle changes can be early indicators of preeclampsia. Trust your instincts, and don't hesitate to speak up if something feels off. Early action can make all the difference for both you and your baby.

Disclaimer: The information provided in this article is for general informational and educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or a qualified healthcare provider with any questions you may have regarding a medical condition.