Chronic ‍Hypertension During Pregnancy Doubles, Medication Use Stagnant

Updated ⁤June 13, 2025

The prevalence of‍ chronic hypertension, or chronic high blood pressure, in pregnant women ‍in⁤ the United⁢ States doubled⁢ between 2008 and 2021, according to research published in the journal Hypertension. Despite this increase, the use of antihypertensive medication during pregnancy⁢ remained ⁣relatively unchanged, hovering around⁣ 60%.

The‍ study, led by Dr. Stephanie⁢ Leonard, an⁢ epidemiologist ‍and assistant professor‍ at Stanford University’s ⁢School of Medicine, examined private health insurance claims data from 2007 to⁤ 2021.Researchers found a steady increase in high blood pressure diagnoses, rising from⁢ 1.8% to 3.7% among nearly 2 million pregnancies.

Chronic hypertension is defined as high⁤ blood pressure diagnosed before ⁤pregnancy or before 20 weeks of gestation. Untreated hypertension can lead to preeclampsia,a condition that can cause organ⁢ damage and increase the risk of future cardiovascular issues for the mother.

The ‍2017 American ⁣Heart Association⁣ and American College ⁢of Cardiology guidelines ⁤lowered the threshold for⁢ diagnosing high blood pressure.‍ However, Leonard noted that this change did not appear to significantly impact medication ⁤usage during pregnancy. “We were surprised to⁣ not find any meaningful changes from before and after the guideline,” Leonard said.

The study also revealed that women diagnosed with high blood ‍pressure during pregnancy were more ‍likely to be 35 or older, reside in the South, and have other⁤ chronic ⁢conditions like obesity, diabetes, or kidney disease.

⁤ ⁢ “This study ⁢highlights the growing burden ⁣of chronic hypertension and poor cardiovascular health pre-pregnancy as critical targets to improve maternal health,” said‍ Dr. Sadiya⁣ S.Khan, chair of the writing ⁤group for the American Heart Association’s 2023 scientific statement on⁣ pre-pregnancy cardiovascular health.

while the use of older medications like methyldopa and hydrochlorothiazide decreased, ‍prescriptions⁢ for labetalol and nifedipine, currently recommended⁢ first-line treatments, increased.

What’s next

Given that ‍nearly one in three individuals with chronic⁤ hypertension may experience pregnancy complications, experts emphasize the importance of prioritizing hypertension prevention and⁢ control to improve maternal health outcomes.