Nutritional Advice El Mondo
Objectives:
Severe hypertension in pregnancy is a hypertensive crisis that requires urgent and intensive care due to its high maternal and fetal mortality. However, there is still a conflict of opinion on the recommendations of antihypertensive therapy.
What are the optimal blood pressure (BP) levels to prevent severe hypertension in pregnant women with nonsevere hypertension?
Study design:
This review article included 40 RCTs with 6,355 patients.
Results and conclusions:
The investigators found blood pressure lowering treatment significantly lowered risk of severe hypertension with 54% [RR = 0.46, 95% CI = 0.37 to 0.56], preeclampsia with 18% [RR = 0.82, 95% CI = 0.69 to 0.98], severe preeclampsia with 62% [RR = 0.38, 95% CI = 0.17 to 0.84], placental abruption with 48% [RR = 0.52, 95% CI = 0.32 to 0.86] and preterm birth with 19% [37 weeks: RR = 0.81, 95% CI = 0.71 to 0.93], while the risk of small for gestational age infants was significantly increased with 25% [RR = 1.25, 95% CI = 1.02 to 1.54].
The investigators found an achieved systolic blood pressure (SBP) of 130 mmHg significantly reduced the risk of severe hypertension to nearly one-third compared with a systolic blood pressure of ≥140 mmHg, with a significant interaction of the blood pressure levels achieved with BP-lowering therapy.
The investigators found there was no significant interaction between the subtypes of hypertensive disorders of pregnancy and blood pressure lowering treatment, except for placental abruption.
The investigators concluded blood pressure lowering treatment aimed at a systolic blood pressure 130 mmHg and accompanied by the careful monitoring of fetal growth should be recommended to prevent severe hypertension in pregnant women with nonsevere hypertension.
Original title:
Optimal blood pressure target to prevent severe hypertension in pregnancy: A systematic review and meta-analysis by Abe M, Arima H, […], Mukoyama M.
Link:
https://pubmed.ncbi.nlm.nih.gov/35136186/
Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and pregnancy right here.