High blood pressure in pregnancy has doubled—but only 60% of women are treated

Pregnancy brings with it all kinds of bodily changes, and it might feel like there are endless things for an expectant mom to worry about. One such concern is gestational hypertension, aka high blood pressure in pregnancy, with a new study showing that rates of pregnancy-induced hypertension (PIH) doubled in recent years—yet only 60% of patients were treated for it. But why?

According to the study, published Monday in the journal Hypertension, rates of chronic hypertension doubled between 2008 and 2021, rising from 1.8% to 3.7% in that 13-year time period. The findings are consistent with other recent studies, which link a sharp increase in the risk for high blood pressure among millennial and Gen Z patients compared to Baby Boomers.

Chronic hypertension in pregnancy is defined as having persistent high blood pressure—which the National Institutes of Health denotes as 140/90 millimeters of mercury (mm Hg) or higher—before pregnancy or within 20 weeks of gestation.

Experts are not 100% clear on the cause, but prior research suggests it might be linked to people waiting until they are older to have children. Some doctors believe poor heart health prior to pregnancy can have an impact, too.

If untreated, gestational hypertension can be dangerous, increasing the risk of complications like preeclampsia, low birth weight, placental abruption (when the placenta separates from the uterus before labor), and kidney problems, among other concerns. It can also increase the risk of several types of heart disease in the future, as Maria Pabon, a cardiologist at Brigham and Women’s Hospital specializing in women’s cardiovascular health, told ABC News. “Heart disease is the number one cause of death of women in the U.S., and women have unique risk factors as compared to men,” she told the outlet.

As for why so many pregnant patients have gone untreated, there are several potential factors, though one doctor believes that 60% might even be an underestimate. Dr. Justin Brandt, an Associate Professor in the Department of Obstetrics and Gynecology at NYU Grossman School of Medicine and the Division Director of Maternal Fetal Medicine, told ABC News that a recent change in guidance might account for the lack of appropriate care in the decades prior.

In 2022, the American College of Obstetricians and Gynecologists (ACOG) updated their guidelines, recommending that patients with even mild hypertension in pregnancy be treated with medication, which might reflect the low treatment rates despite rising numbers from 2008 to 2021.

“Our approach really changed. We realized that treatment reduced complications in pregnancy like preeclampsia without affecting fetal growth,” Brandt said.

Of course, a lack of access to adequate health care during pregnancy is a very real problem, one that disproportionately affects Black patients and other patients of color. These disparities “reflect neighborhood, economic and health-systems level factors that shape access to care and health during pregnancy,” as Natalie A. Cameron, MD, an instructor at Northwestern Medicine, previously told Motherly.

With updated guidance, hopefully more patients will receive the care and support they need to carry out a healthy pregnancy. Checking in with your doctor with any concerns is always a good idea, and you can take some small steps at home to lower blood pressure during pregnancy: reducing sodium intake, eating a diet rich in whole grains and potassium, increasing water intake, managing stress through relaxation techniques, staying active, avoiding smoking and alcohol, and taking medications as prescribed.

A holistic approach can help reduce your risks, with full acknowledgment that not every pregnant patient has the same resources available to them—all the more reason why equitable healthcare access is so important, during pregnancy and beyond.