High blood pressure medicine after pregnancy



High Blood Pressure After Pregnancy

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High Blood Pressure in Pregnancy

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The Information Standard

Dr Jacqueline Payne, 30 Oct 2017

In this series

In this article

  • Arrow-downWhat is high blood pressure?
  • Arrow-downWhat are the different types of high blood pressure in pregnancy?
  • Arrow-downHow common is high blood pressure during pregnancy?
  • Arrow-downWhat are the possible problems with high blood pressure during pregnancy?
  • Arrow-downHow do I know if I have high blood pressure whilst I am pregnant?
  • Arrow-downWhat is the treatment for high blood pressure in pregnancy?

High Blood Pressure in Pregnancy

In this article

What is high blood pressure?

If you have high blood pressure (hypertension), the pressure of the blood in your blood vessels (arteries) is too high. Blood pressure is recorded as two figures. For example, 140/85 mm Hg. This is said as “140 over 85”. Blood pressure is measured in millimetres of mercury (mm Hg). The first (or top) number is your systolic blood pressure. This is the pressure in your arteries when your heart contracts. The second (or bottom) number is your diastolic blood pressure. This is the pressure in your arteries when your heart rests between each heartbeat.

Normal blood pressure is below 140/90 mm Hg. During pregnancy:

  • Mildly high blood pressure is blood pressure between 140/90 and 149/99 mm Hg (ie the systolic or upper number is between 140 and 149, and/or the lower or diastolic number is between 90 and 99).
  • Moderately high blood pressure is blood pressure between 150/100 and 159/109 mm Hg. (The systolic is between 150 and 159 and/or the diastolic is between 100 and 109.)
  • Severely high blood pressure is blood pressure of 160/110 mm Hg or higher. (The systolic is 160 or more, and/or the diastolic is 110 or more.)

Our blood pressure goes up when we are anxious or stressed, such as when we have to rush. Some people find it stressful seeing a doctor or midwife. It is important to give yourself enough time for your antenatal appointments so that you can relax and your blood pressure is not higher than it normally would be. Your employer is obliged to give you adequate time off work to attend antenatal appointments. If your blood pressure is high when you attend the clinic but normal when, for example, your midwife takes your blood pressure at home, this is called “white coat” hypertension. See separate leaflet called Home and Ambulatory Blood Pressure Recording.

What are the different types of high blood pressure in pregnancy?

Pre-existing high blood pressure

Some women already have high blood pressure (hypertension) Before they become pregnant and they may be on treatment for this. Some women are found to have high blood pressure Before they are 20 weeks pregnant. (If high blood pressure is first discovered before you are 20 weeks pregnant, this usually means that you had previously undetected high blood pressure before you were pregnant.)

So, high blood pressure before 20 weeks of pregnancy is not caused by pregnancy but is pre-existing, or chronic, high blood pressure. There are various causes. See separate leaflet called High Blood Pressure (Hypertension).

If you have pre-existing high blood pressure, you have an increased risk of developing pre-eclampsia during your pregnancy (see below).

Note: if you are taking medicines to treat high blood pressure then, ideally, you should have this reviewed Before you become pregnant. Some medicines that are used to treat high blood pressure should not be taken during pregnancy – for example, medicines called:

  • Angiotensin-converting enzyme (ACE) inhibitors.
  • Angiotensin-II receptor antagonists (AIIRAs) – sometimes called angiotensin receptor blockers (ARBs).
  • ‘Water’ tablets (diuretics).

This is because these medicines may harm a developing baby. If you are taking one of these medicines then it is very likely that your medicine will be changed to another medicine that is not known to harm a developing baby.

Gestational high blood pressure

Some women can develop New high blood pressure during their pregnancy. This is called gestational high blood pressure (or hypertension) or pregnancy-induced high blood pressure (or hypertension).

Gestational high blood pressure is high blood pressure that develops for the first time after the 20th week of pregnancy. Doctors can confirm this type of high blood pressure if you do not go on to develop pre-eclampsia during your pregnancy (see below) And if your blood pressure has returned to normal within six weeks of giving birth. If you have gestational high blood pressure, you do not have protein in your urine when it is tested by your midwife or doctor during your pregnancy.

Note: some women may be found to have new high blood pressure after 20 weeks of pregnancy. At first, they may not have any protein in their urine on testing. However, they may later develop protein in their urine and so be diagnosed with pre-eclampsia (see below). You are only said to have gestational hypertension if you Do not go on to develop pre-eclampsia during your pregnancy.

Pre-eclampsia and eclampsia

Pre-eclampsia is a condition that can affect some women who develop new high blood pressure after the 20th week of their pregnancy. Pre-eclampsia can also sometimes develop in women who have high blood pressure before they are pregnant (pre-existing high blood pressure) or in women who have protein in their urine before they are pregnant (for example, due to kidney problems).

Pre-eclampsia not only causes high blood pressure; it also affects other parts of your body such as your kidneys, liver, brain and blood clotting system. Pre-eclampsia causes protein to leak from your kidneys into your urine. If you have pre-eclampsia, you will have high blood pressure and protein will be found in your urine when it is tested. Pre-eclampsia gets better within six weeks of you giving birth.

Eclampsia can be a complication of pre-eclampsia. In eclampsia, a woman with pre-eclampsia has one or more fits (seizures or convulsions). This is a serious condition. The aim is to detect and treat pre-eclampsia successfully to try to prevent eclampsia from developing.

How common is high blood pressure during pregnancy?

High blood pressure (hypertension) during pregnancy is quite a common problem.

  • About 1 in 10 pregnant women have problems with high blood pressure.
  • Up to 3 in 100 pregnant women have pre-existing high blood pressure.
  • About 4 to 8 in 100 pregnant women have gestational high blood pressure and do not go on to develop pre-eclampsia.
  • Between 2 and 8 in 100 pregnant women develop pre-eclampsia.
  • For every 100 women who have already developed pre-eclampsia in one pregnancy, 16 will develop it again in a future pregnancy. Up to half of these women will develop gestational hypertension in a future pregnancy.

Problems with new high blood pressure are more common during your first pregnancy.

What are the possible problems with high blood pressure during pregnancy?

As a rule, the higher your blood pressure, the greater the risk for you and your baby.

Mild-to-moderate high blood pressure

If your blood pressure remains mildly to moderately raised and you do not develop pre-eclampsia then the risk is low. Most women with high blood pressure (hypertension) during pregnancy just have mildly or moderately raised blood pressure. However, it is important that your blood pressure and urine should be checked regularly throughout your pregnancy and that you look out for any signs of possible pre-eclampsia (see below).

Severe high blood pressure or pre-eclampsia

Severe high blood pressure, especially with pre-eclampsia, is serious.

  • The risks to you as the mother include:
    • An increased chance of having a stroke.
    • Damage to your kidneys and liver.
    • An increased risk of blood clotting problems.
    • An increased risk of severe bleeding from your placenta.
    • Having fits (seizures) if you go on to develop eclampsia.
  • The risks to your baby include:
    • An increased chance of poor growth.
    • An increased chance of premature birth.
    • An increased chance of stillbirth.

How do I know if I have high blood pressure whilst I am pregnant?

Many women with high blood pressure (hypertension) during their pregnancy do not have any symptoms. This is why your blood pressure is checked regularly by your doctor or midwife during your pregnancy. Your urine is also tested regularly for protein, to look for possible pre-eclampsia.

However, there are some symptoms that you should look out for that could be signs of pre-eclampsia. If you develop any of these, you should see your doctor or midwife Urgently so that they can check your blood pressure and test your urine for protein. They include:

  • Severe headaches that do not go away.
  • Problems with your vision, such as blurred vision, flashing lights or spots in front of your eyes.
  • Tummy (abdominal) pain. The pain that occurs with pre-eclampsia tends to be mainly in the upper part of the abdomen, just below your ribs, especially on your right side.
  • Vomiting later in your pregnancy (not the morning sickness of early pregnancy).
  • Sudden swelling or puffiness of your hands, face or feet.
  • Feeling out of breath.
  • Not being able to feel your baby move as much.
  • Just not feeling right.

Note: swelling or puffiness of your feet, face, or hands (oedema) is common in normal pregnancy. Most women with this symptom do not have pre-eclampsia but it can become worse in pre-eclampsia. Therefore, report any sudden worsening of swelling of the hands, face or feet promptly to your doctor or midwife.

What is the treatment for high blood pressure in pregnancy?

If your doctor or midwife finds that your blood pressure is high during your pregnancy, they will usually check to see if you have any protein in your urine and ask you if you have any symptoms of pre-eclampsia. If your blood pressure remains high, or if you have any signs of pre-eclampsia, you will usually be seen by a specialist (an obstetrician). In order to advise on treatment, there are various questions that need to be considered by the specialist, such as:

  • How severe is your high blood pressure (hypertension)?
  • Is there pre-eclampsia and, if so, how severe is it?
  • How far on is your pregnancy?
  • What are the risks to you, the mother, and your baby? This will depend on the severity of your high blood pressure and whether or not pre-eclampsia is present.

If high blood pressure remains mild and pre-eclampsia does not develop

There is usually little risk. Regular checks of your blood pressure and your urine for protein, as well as checks to see how your pregnancy is progressing, may be all that is needed until the natural time of birth. Checks may include blood tests and an ultrasound scan to look at how your baby is growing and to check the blood flow from the afterbirth (placenta) to the baby. You may be followed up by an obstetrician. You may need medicines to control your blood pressure during your pregnancy.

If high blood pressure becomes severe, or if pre-eclampsia develops

There are risks to both you, as the mother, and to your baby if high blood pressure becomes more severe, especially if you develop pre-eclampsia. You will usually be seen urgently by a specialist and you may be admitted to hospital. Blood tests may be suggested to check to see how much your blood pressure or pre-eclampsia is affecting you. The well-being of your baby may also be checked using ultrasound scanning. A recording of your baby’s heart rate may be carried out.

For severe high blood pressure, especially if pre-eclampsia develops, there is often a dilemma. If the high blood pressure is caused by the pregnancy, the only cure is to deliver your baby. This may be fine if your pregnancy is near to the end. The birth can be induced, or your baby can be born by caesarean section if necessary. However, a difficult decision may have to be made if high blood pressure or pre-eclampsia becomes severe earlier in your pregnancy.

Medicine to lower the blood pressure may be prescribed for a while. The most commonly used medicine is labetalol. This may allow your pregnancy to progress further before delivering your baby. The best time to induce the birth (or deliver by caesarean section) varies depending on the factors mentioned above.

If you have severe pre-eclampsia, the medicine magnesium sulfate may be given via a drip around the time that your baby is delivered. This may reduce your chance of developing eclampsia and prevent you having fits (seizures).

There is some evidence to suggest that regular low-dose aspirin and calcium supplements may help to prevent pre-eclampsia in some women who may be at increased risk of developing it. Your specialist may recommend you take one or both of these. They will be able to discuss this with you in more detail.

Pre-eclampsia, Eclampsia and HELLP Syndrome

High blood pressure during pregnancy

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High blood pressure can cause problems for you and your baby during pregnancy, including preeclampsia and premature birth.

High blood pressure usually doesn’t cause signs or symptoms. Go to all your prenatal care visits so your provider can check your blood pressure.

If you need medicine to keep your blood pressure under control, take it every day.

If you’re at high risk for preeclampsia, your provider may want you to take low-dose aspirin to help prevent it.

What is high blood pressure?

Blood pressure is the force of blood that pushes against the walls of your arteries. Arteries are blood vessels that carry blood away from your heart to other parts of the body. If the pressure in your arteries becomes too high, you have high blood pressure (also called hypertension). High blood pressure can put extra stress on your heart and kidneys. This can lead to heart, disease, kidney disease and stroke.

Some women have high blood pressure before they get pregnant. Others have high blood pressure for the first time during pregnancy. About 8 in 100 women (8 percent) have some kind of high blood pressure during pregnancy. If you have high blood pressure, talk to your health care provider. Managing your blood pressure can help you have a healthy pregnancy and a healthy baby.

How do you know if you have high blood pressure?

Your blood pressure reading is given as two numbers: the top (first) number is the pressure when your heart contracts (gets tight) and the bottom (second) number is the pressure when your heart relaxes. A normal blood pressure is 119/79 or lower. High blood pressure happens when the top number is 140 or greater, or when the bottom number is 90 or greater. Your blood pressure can go up or down during the day.

At each prenatal care checkup, your provider checks your blood pressure. To do this, she wraps a cuff (band) around your upper arm. She pumps air into the cuff to measure the pressure in your arteries when the heart contracts and then relaxes. If you have a high reading, your provider can recheck it to find out for sure if you have high blood pressure.

What pregnancy complications can high blood pressure cause?

High blood pressure can cause problems for you and your baby during pregnancy, including:

  • Preeclampsia. This is when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Signs and symptoms of preeclampsia include having protein in the urine, changes in vision and severe headaches. Preeclampsia can be a serious medical condition. Even if you have mild preeclampsia, you need treatment to make sure it doesn’t get worse. Without treatment, preeclampsia can cause kidney, liver and brain damage. In rare cases, it can lead to life-threatening conditions called eclampsia and HELLP syndrome. Eclampsia causes seizures and can lead to coma. HELLP syndrome is when you have serious blood and liver problems.
  • Premature birth. This is birth that happens too early, before 37 weeks of pregnancy. Even with treatment, a pregnant woman with severe high blood pressure or preeclampsia may need to give birth early to avoid serious health problems for her and her baby.
  • Low birthweight. This is when a baby is born weighing less than 5 pounds, 8 ounces. High blood pressure can narrow blood vessels in the uterus (womb). Your baby may not get enough oxygen and nutrients, causing him to grow slowly.
  • Placental abruption. This is a serious condition in which the placenta separates from the wall of the uterus before birth. If this happens, your baby may not get enough oxygen and nutrients in the womb. You also may have serious bleeding from the vagina. The placenta grows in the uterus and supplies the baby with food and oxygen through the umbilical cord.

If you have high blood pressure during pregnancy, you’re also more likely have a cesarean birth (also called c-section). This is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.

What kinds of high blood pressure can affect pregnancy?

Two kinds of high blood pressure that can happen during pregnancy:

  • Chronic hypertension. This is high blood pressure that you have before you get pregnant or that develops before 20 weeks of pregnancy. It doesn’t go away once you give birth. About 1 in 4 women with chronic hypertension (25 percent) has preeclampsia during pregnancy. If you’re at high risk for preeclampsia, your provider may treat you with low-dose aspirin to prevent it.

How can you manage high blood during pregnancy?

Here’s what you can do:

  • Go to all your prenatal care checkups, even if you’re feeling fine.
  • If you need medicine to control your blood pressure, take it every day. Your provider can help you choose one that’s safe for you and your baby.
  • Eat healthy foods. Don’t eat foods that are high in salt, like soup and canned foods. They can raise your blood pressure.
  • Stay active. Being active for 30 minutes each day can help you manage your weight, reduce stress and prevent problems like preeclampsia.
  • Don’t smoke, drink alcohol or use street drugs or abuse prescription drugs.

What can you do about high blood pressure before pregnancy?

Here’s what you can do:

  • Get a preconception checkup. This is a medical checkup you get before pregnancy to take care of health conditions that may affect your pregnancy.
  • Use birth control until your blood pressure is under control. Birth control is methods you can use to keep from getting pregnant.
  • Get to a healthy weight. Talk to your provider about the weight that’s right for you.
  • Eat healthy foods.
  • Do something active every day.
  • Don’t smoke. Smoking is dangerous for people with high blood pressure because it damages blood vessel walls.

Pregnancy and High Blood Pressure

Pregnancy is the most important phase of women’s life. Pregnancy is a critical stage and even slight unwanted change in normal process can be vital to both mother and baby. Pregnant women needs to be careful about various aspects like food to be eaten, type of work they can do, what kind of medicines to use or to avoid, type of exercise to be done etc. one important health factor which is necessary to control during pregnancy is blood pressure. High blood pressure (HBP) may risk the life of both mother and baby. More idea about relation between pregnancy and high blood pressure can be acquired form this article. Apart from regulating BP in pregnancy phase, it is equally important to keep eye on BP before and after pregnancy.

High blood pressure Before Pregnancy

Some women’s may already have pre-existing high blood pressure. Some changes which are needed to be done before planning a pregnancy is to have

  • Healthy diet
  • Regular exercise
  • Proper weight depending upon your height
  • Quit smoking
  • Quit alcohol

Folic acid supplements should also be taken before 3 months of planned pregnancy and should be continued for first 3 months after getting pregnant. If a woman already has HBP, she should consult doctor before planning a pregnancy. He may advice whether you need medicine to control BP or can stop the treatment during early phase of pregnancy you about what kind of drugs are safe during pregnancy. Having HBP doesn’t mean that you shouldn’t plan for pregnancy.

BP lowering drugs for Pregnancy

Pregnancy lasts for 38 to 42 weeks and is divided in to 3 phases called trimester. First 13 weeks (first trimester) is the period during which baby forms. Second trimester is from 14-27 weeks which is very crucial as organ development takes place during this phase and third trimester extends from 28 weeks until the birth and it is the phase where baby gets matures enough to survive. Babies are at most risk to drugs during second trimester phase.

The idea about safety of drugs can be gathered only from animal studies. No clinical study can be done in pregnant women or in women during their reproductive stages, so idea of toxic effects can be acquired only through reports of bad outcomes when pregnant women have inadvertently taken those drugs. Since there is more idea about the safety of older antihypertensive drugs than newer ones, it is recommended for women with high blood pressure to have older generation BP lowering drugs than newer ones either before pregnancy or at early stages of pregnancy.

Methyldopa even if it is considered as an old fashion drugs is the safest and most effective drugs and is suitable for use at all stages of pregnancy. Beta blockers are suggested but after 24 weeks of pregnancy because reports have shown that they may interfere with baby’s growth when given at early stages of pregnancy. Atenolol should be avoided because it leads to impaired baby growth. Less safety data is available for calcium channel blocker so it should be prescribed only if necessary and only at late stages of pregnancy.

Diuretics and ACE inhibitors are should be avoided completely during pregnancy because they may make pre-eclampsia worse. Also new drugs which are less evaluated during pregnancy should be avoided.

Pregnancy and High Blood Pressure

Blood pressure generally falls during pregnancy. The decline in blood pressure is observed in second trimester period and then it slowly rises until the baby is born. During pregnancy, baby fulfils all it’s the nutritional need from the blood supply by mother. Exchange of oxygen and nutrients from mother to baby is done via placenta. It can be understood that as the baby matures, more amount of blood is needed to be supplied to baby therefore blood volume in mother’s body increases which can cause rise in blood pressure. The placenta releases hormones which relax the walls of arteries and veins and they expand to facilitate storage of such large volume of blood and thus BP remains unaffected. However rise in BP may be observed at latter stages of pregnancy. If the rise in BP is observed for the first time in 36 weeks, it is considered as the best time to deliver baby. If BP rises between 24-36 week periods, you may require BP lowering drug to control BP as to delay the labour. The blood pressure for pregnant women above 140/90mmHg is considered as fatal. If BP reads 170/110mmHg, the women need to be hospitalised as she require immediate medical attention. The condition of Rise in blood pressure during pregnancy is known as eclampsia which is discussed in next section.

Pre-eclampsia and Pregnancy

We have discussed that blood pressure falls during pregnancy, but in many situation rise in blood pressure is observed in pregnant women especially at late stage of pregnancy. A situation where blood pressure rises during pregnancy is called as pre-eclampsia. The rise in BP could not be considered as the only parameter suspecting development of pre-eclampsia so, high protein in urine and oedema confirms the presence of pre-eclampsia. No signs or symptoms are observed at the early stages so the only media through which you can detect this disease is via regular antenatal check-up. 5% of women suffer from pre-eclampsia in their first pregnancy. In majority of pregnant women, pre-eclampsia is developed but in mild form and blood pressure gets normal by itself after delivery of baby. But around 1 woman in 250 may get more severe form of pre-eclampsia. The chances of pre-eclampsia are more in a woman who gets pregnant after age of 40 or if she is already has high blood pressure. It is believed that women with pre-existing high BP has 2-10 times higher risk than women who had normal BP before pregnancy. Also risk increases by 2-4 folds more if there’s a family history of pre-eclampsia and by 10 fold if both mother and sister have suffered from pre-eclampsia during their pregnancy. Also note that about one third women who had pre-eclampsia in their first pregnancy gets mild pre-eclampsia in their second pregnancy. Blood pressure can be controlled in women with pre-eclampsia but it can be cured only after the delivery of baby but there may be risk of death or disability with baby.

But if blood pressure raises too high or no proper measures have been taken to control it, the more serious problem can arise – known as Eclampsia. The word Eclampsia which is derived from Greek word that means ‘flashing light’ because the first thing that women suffering eclampsia sees is flashing lights before fits develop. Fits or seizure is the main symptom of eclampsia. Soon after, condition becomes more severe as women may lose consciousness which is followed by spasm of all muscles and body starts shaking uncontrollably and in symmetrical order. It can be dangerous to both mother and baby. But the cases of eclampsia have dropped down because of developed and proper antenatal care. Another condition called as fulminating pre-eclampsia, same as eclampsia but more severe because in such situation blood pressure rises suddenly even if no previous sign of rise in BP is recorded. Eclampsia or fulminating pre-eclampsia can be treated by giving BP lowering drugs and delivering baby as soon as possible by inducing labour or through caesarean section. Another way to control fits is by injecting magnesium supplements (Epsom salts).

Pregnancy and high blood pressure are strongly related since the major cause of eclampsia is high blood pressure; let’s focus more on pre-eclampsia because fits can be avoided only if blood pressure is controlled at this stage. Under condition of pre-eclampsia, arteries of placenta are not able to penetrate deep in to the walls of artery and gets narrow by the plaque and clot formation as a result placental blood supply decreases and thus blood volume increases throughout the body which results in rise in BP. pre-eclampsia may lead to premature birth. under this condition baby may be born with less weight, takes more time to establish good feeding pattern or may have physical disability ( in case of severe pre-eclampsia). The pre-eclampsia occurs when BP rises above 140/90 mmHg. You may have mild pre-eclampsia if diastolic blood pressure is between 90-99mmHg, moderate if diastolic BP lies between 100-109mmHg and severe if it goes above 110mmHg. Another way to identify pre-eclampsia is by Observing difference in BP before pregnancy and BP at late stage of pregnancy, if pre-pregnancy readings are not available, observe the difference in BP in early and late stage of pregnancy. If diastolic and systolic BP rises by 15mmHg and 30mmHg respectively, pre-eclampsia is present.

Another parameter that identifies pre-eclampsia is protein content in urine. If the amount of protein secreted in 24hrs period is more than 300mg, presence of pre-eclampsia is confirmed. Urine test is done to determine protein level. The rise in protein level in urine is due to kidney damage. Sometimes during pregnancy, the blood pressure rises so promptly that may results in kidney damage as kidney may not be able to adjust to sudden rise in blood pressure. Be careful while collecting urine specimen, it is normally suggested to take midstream (MSU) specimen by passing out little urine before collecting sample into container.

Next condition is oedema. Let me make you clear that oedema or swelling happens commonly to the pregnant women. If there’s no protein content in urine, and still you observe swelling, it means that you are safe from pre-eclampsia. But in case of pre-eclampsia, excess of protein gets excreted out which causes increase in volume of fluid that leaks out from the wall of capillary and causes swelling in most of the parts of body mainly in legs. Pre-eclampsia can also be suspected when doctors observe poor growth in baby while observing abdomen or when mother reports with decrease in baby movement.

Pre-eclampsia can be treated only by delivering baby. The doctors have to be careful regarding the extent of severity of pre-eclampsia, stage of pregnancy and decide accordingly to induce labour or plan caesarean section. Labour can be induced by breaking your water called as artificial rupture of membrane (ARM) or by giving prostaglandin pessaries or gel into vagina. Oxytocin injection can be given to induce uterine contraction if the above two methods fails.

High Blood Pressure after Pregnancy

Blood pressure drops down during pregnancy or gets elevated in case of pre-eclampsia. But after delivery blood pressure drops down to normal level in 6 weeks’ time period. Under any situation, if your blood pressure stays elevated even after 6 week period you need to start with BP lowering drug. Regular medical check-up is necessary to keep eye on BP level. Next thing to keep in mind is avoid use of drugs that may pass into breast milk in breast feeding women. BP Lowering drugs which are considered safe to be used during pregnancy is also safe for breast feeding women except methyl dopa because it may lead to depression. Thus methyl dopa should be avoided after delivery. Therefore Drugs like calcium channel blocker and beta blocker which are safe during pregnancy can be continued even after pregnancy.

Contraception and High Blood Pressure

Although contraceptives are not related to pregnancy and high blood pressure, but contraceptive medicines doo contribute in raising high blood pressure. There are two forms of contraceptive pills – combined oral contraceptive (COC) progesterone only pills (POP). POP are less effective than COC but effect on blood pressure is less than COC because it was observed that COC increases BP by 5/3mmHg and also risk of heart attack and stroke was more in case of COCs. COCs consists of combination of two different hormones – oestrogen and progesterone. Different generation of progesterone are available and plus point is the fact that drugs of different generation have same effect on heart. Although it was found that risk of venous thromboembolism was more with third generation progesterone like desogestrel or gestodene than second generation drug like levonorgestrol.

Women should stop taking COCs if they already have high blood pressure or any cardiovascular disorder and BP check-up should be done after every 6 months. Switching to POP can be other solution to COC as they are not associated with rise in BP.

Menopause and High Blood Pressure

Menopause is a period in women’s life where her menstrual period eventually stops. Menopause can occur in between age of 45-55 years. Many people believe during menopause phase blood pressure. This is not true because blood pressure normally rises with age and menopause has no effect in blood pressure. During menopause women may observe palpitation and flushing. These symptoms can be avoided using hormone replacement therapy (HRT). it reduces palpitations, flushing or mood swings and sleep disturbances. HRT can also help in reducing risk of osteoporosis and colon cancer. The benefits of HRT may be outweighed by the fact that it may increase the risk of venous thromboembolism, breast cancer and endometrial cancer. Recent studies have shown that HRT my increase the risk of cardiovascular disorder in women who have previously suffer from coronary heart disease. so it is necessary to have BP test for at least 2-3 times in first 6 months and then after every 6 months if you start undergoing HRT.

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