New ACC/AHA Guidelines Detect More Cases of Gestational Hypertension

Adopting the 2017 American College of Cardiology/American Heart Association guidelines for hypertension resulted in an increase in the prevalence of high blood pressure in pregnant women, according to a study published in the issue of Circulation Research.

In an effort to assess the impact of adopting the 2017 ACC/AHA guideline on detecting gestational blood pressure elevations, Jie Hu, M.D., Ph.D., of Brigham and Women's Hospital in Boston, and colleagues studied the systolic and diastolic blood pressures of 16,345 women in China, captured at up to 22 prenatal visits during different stages of pregnancy.

The researchers found that using the 2017 ACC/AHA hypertension guidelines resulted in 25.1 percent of women (4,100) being diagnosed with gestational hypertension compared with 4.2 percent (678) using the previous Seventh Report of the Joint National Committee guidelines. Gestational hypertension, but not subclinical blood pressure elevation, correlated significantly with altered indicators of liver, renal, and coagulation functions during pregnancy for mothers and an increased risk for adverse birth outcomes for newborns (adjusted odds ratios for gestational hypertension stage 2: 2.23, 2.05, 1.43 for preterm delivery, early-term delivery, and small for gestational age, respectively).

"Incorporating the 2017 ACC/AHA guidelines into prenatal care practice could improve detection of high blood pressure during pregnancy and the efforts to reduce adverse maternal and neonatal outcomes in the perinatal period that are related to gestational hypertension," Hu said in a statement.

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