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Review
. 2023 Mar 1;32(2):153-164.
doi: 10.1097/MNH.0000000000000857. Epub 2022 Nov 16.

Hypertension in Pregnancy: What We Now Know

Sonali Gupta  1 , Lohana Petras  2 , Muhammad Umer Tufail  2 , Juan Diego Rodriguez Salazar  2 , Belinda Jim  2
Affiliations
Review

Hypertension in Pregnancy: What We Now Know

Sonali Gupta et al. Curr Opin Nephrol Hypertens. .

Abstract

Purpose of review: Hypertensive disorders of pregnancy remain a highly morbid condition that affects both the mother and fetus, complicate approximately 10% of pregnancies worldwide, and contribute to immediate and long-term cardiovascular outcomes. There is still much to learn regarding pathogenesis and treatment goals.

Recent findings: There is updated information on the pathogenesis of preeclampsia and treatment thresholds for HTN in pregnancy. l-Kynurenine, a metabolite of the essential amino acid l-tryptophan, has been implicated in preeclampsia as decreased levels were found in a uninephrectomized pregnant mouse model of preeclampsia, where replacement of l-kynurenine rescued the preeclamptic state. Further, data from CHIPS (The Control of HTN in Pregnancy Study) and CHAP (Chronic HTN and Pregnancy) trials demonstrate not only the safety of lowering blood pressure to either a diastolic goal of 85 mmHg (CHIPS) or less than 160/105 mmHg (CHAP) without detriment to the fetus but the CHAPS trial has also shown a decrease in the rate of preeclampsia in the treatment group.

Summary: We will summarize the different types of hypertensive disorders in pregnancy, updates on the pathogenesis of preeclampsia, and appropriate HTN management based on the latest evidence in order to better care for mother and child.

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References

    1. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol 2013; 122:1122–1131.
    1. Clapp JF 3rd, Capeless E. Cardiovascular function before, during, and after the first and subsequent pregnancies. Am J Cardiol 1997; 80:1469–1473.
    1. Sanghavi M, Rutherford JD. Cardiovascular physiology of pregnancy. Circulation 2014; 130:1003–1008.
    1. Knock GA, Poston L. Bradykinin-mediated relaxation of isolated maternal resistance arteries in normal pregnancy and preeclampsia. Am J Obstet Gynecol 1996; 175:1668–1674.
    1. Gant NF, Worley RJ, Everett RB, MacDonald PC. Control of vascular responsiveness during human pregnancy. Kidney Int 1980; 18:253–258.