What research tells us about preeclampsia and gestational hypertension

by Theresa Buckley DNP, APRN, CNM

After more than 25years in nursing, including 16 years as a Certified Nurse Midwife, I recently completed my Doctorate in Nursing Practice (DNP) as a way of furthering my commitment to providing my patients the best evidence-based care. 

A DNP-prepared practitioner strives to implement what is learned through research into clinical practice. In my doctoral research, my area of focus was cardiovascular disease after a hypertension disorder of pregnancy.

Among several hypertension disorders of pregnancy, the most common are preeclampsia and gestational hypertension. Preeclampsia (PE) occurs after 20 weeks of pregnancy when the blood pressure is elevated (>140/>90) with protein in the urine. Gestational hypertension also happens after 20 weeks of pregnancy, with elevated blood pressure but no protein in the urine.

According to the Preeclampsia Foundation, preeclampsia doubles a woman’s risk of heart disease and stroke. These complications can develop over 5-15 years after the pregnancy. Preeclampsia also quadruples the risk of developing high blood pressure later in life. Two out of three women who experienced preeclampsia will die from cardiovascular disease.

Cardiovascular disease is a leading cause of death among women. Cardiovascular disease risk screening is important for the prevention of future disease. When you are at higher-than-average risk, it is important to make changes today for a healthier tomorrow, especially after a pregnancy complicated with blood pressure problems. Pregnancy history cannot be changed, but there are things that can be changed which will lower the risk of heart disease and stroke. Diet, exercise and stopping smoking are some things that can be changed to lower the risk of cardiovascular dise:

• Physical activity: walk for 30 minutes, five times a week
• Eat a heart-healthy diet: a Dietary Approaches to Stop Hypertension (DASH) diet is high in fiber, vegetables, and fruits and low in fats
• Maintain a healthy weight: a healthy BMI between 18.5-25
• Stop smoking
• Understand numbers
  • Blood pressure should stay around 120/80
  • Total cholesterol < 200mg/dl
  • LDL (bad cholesterol) < 100 mg/dl
  • HDL (good cholesterol) > 50mg/dl
  • Triglycerides < 150mg/dl

If you experienced a pregnancy that was complicated with preeclampsia or gestational hypertension, become proactive in your health care. Understand your pregnancy history puts you at risk for cardiovascular disease. Not everybody who had these complications will develop heart problems. Knowledge is power. Acknowledge that you may be at risk, and take the opportunity NOW to make changes for a healthier future. Don’t wait five years, 10 years, or 15 years until you are diagnosed with heart disease. By then, the change may be too late.

Learn more about preeclampsia from the Preeclampsia Foundation.  

Read my dissertation.