Study: Hypertension pregnancy complications have almost doubled

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Findings from the American Heart Association found 80,000 pregnancies were complicated by high blood pressure

Initial research from the American Heart Association has found that the rate of high blood pressure pregnancy complications has nearly doubled in the past 11 years.

The findings, which were announced by the nonprofit organization Monday, show that nearly twice as many pregnancies were complicated by hypertension in 2018 than in 2007. Additionally, women living in rural areas continue to have higher rates of high blood pressure compared to women living in urban areas. This research is to be presented virtually at the American Heart Association’s Scientific Sessions 2020 beginning Friday, Nov. 13.

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“Trends and Disparities in Pre-pregnancy Essential Hypertension Among Women in Rural and Urban United States, 2007-2018” was a study aimed at explaining trends in maternal pre-pregnancy high blood pressure to develop geographically targeted prevention and policy strategies. It’s been well established that pre-pregnancy hypertension risks the health of mothers and infants alike. Death rates of U.S. mothers are increasing and there is a notable disparity between rural and urban communities.

“We were surprised to see the dramatic increase in the percentage over the last 10 years of women entering pregnancy with hypertension," the study’s lead author Dr. Natalie A. Cameron, a resident in the department of medicine at Northwestern University’s Feinberg School of Medicine in Chicago, said in a statement. "It was also shocking to see women as young as 15 to 24 years old with high blood pressure, and the statistics were worse in rural areas, leading us to be concerned these numbers may, in part, be driven by hospital closures and difficulty accessing care.”

Using the Centers for Disease Control and Prevention’s national Natality Database, researchers obtained maternal data from nearly 50 million live births in women ages 15 to 44. The data was collected between 2007 and 2018.

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Scientists calculated rates of pre-pregnancy high blood pressure per 1,000 live births overall and by whether women lived in rural or urban communities. To compare yearly rates between each community, the annual percentage change was computed.

Results showed that women living in rural and urban areas had nearly double the rate of pre-pregnancy hypertension. Additionally, women ages 15-19 had lower high blood pressure rates than women ages 40-44 in both areas, but all age groups had a similar increase in rates from 2007 and 2018. For women in rural areas, the greatest annual percentage change of pre-pregnancy hypertension was nearly 10%; for women in urban areas, it was 9%.

“These data demonstrate unacceptable increases in the number of women with hypertension that need to be addressed urgently,” Cameron said. “Preventive care must start before pregnancy. This is especially important in rural communities where there is a far greater burden of high blood pressure and much higher risks to the health of mother and baby. We also must address the structural and systemic racism that can be barriers to high quality care.”

According to March of Dimes, high blood pressure usually has no symptoms or signs, so it’s important for women to attend all prenatal visits so a doctor can check for hypertension. Among the pregnancy complications that high blood pressure can cause are gestational diabetes, placental abruption and preeclampsia, where signs show some of a pregnant woman’s organs may not be working right.

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