March 7, 2025
High blood pressure during pregnancy is on the rise
The keys to preventing cardiovascular conditions during pregnancy are knowing your risk factors and taking preventive measures.
Many risk factors for pregnancy-induced hypertension are the same as for hypertension unrelated to pregnancy. The condition is more common and severe in Black women.
Pregnancy is a time of joy and anticipation for most families, but over the last several years, doctors like Sonia Novotny, ob-gyn, Kaiser Permanente of Colorado, have seen a troubling trend: a steep rise in the number of pregnant women with high blood pressure.
Since 2007, high blood pressure during pregnancy has doubled among women in the U.S. Also known as pregnancy-induced hypertension, PIH is part of a spectrum of disorders that can include preeclampsia and eclampsia, which are leading causes of maternal death.
The keys to preventing PIH, according to Dr. Novotny, are knowing your risk factors and taking preventive measures.
Risk factors
Many PIH risk factors are the same as they are for hypertension unrelated to pregnancy. PIH is more common and severe among Black women. Altitude also can play a role.
In addition, having a body mass index greater than 35, Dr. Novotny said, or being more than 40 years old at the time of delivery can put women at higher risk.
“As we age, there’s more happening in our cardiovascular system,” Dr. Novotny said. "And those things make a big difference in pregnancy, because pregnancy is essentially a stress test for your heart.”
Women can have up to 40% more blood volume during pregnancy, she said.
For women who are pregnant or want to become pregnant, it can be important to know your family history. Care teams typically discuss that history at a patient’s first pregnancy visit with their ob-gyn, Dr. Novotny said. A family history of heart disease, stroke, cardiomyopathy, or sudden death are all risk factors. People at higher risk may require additional tests for proper heart, liver, and kidney function, Dr. Novotny said.
Prevention is key
Maintaining physical activity and eating healthy foods before and during pregnancy can be critical to avoiding PIH.
“We know that it is safe to be active in pregnancy at the same intensity that you were before,” Dr. Novotny said. But even something as simple as walking helps keep pregnancy-related weight gain at a healthy level.
When it comes to diet, Dr. Novotny said to avoid simple starches. Foods high in sugar, refined carbohydrates, saturated fat, and sodium have been linked with diabetes. Diabetes during pregnancy, or gestational diabetes, can put moms at risk for cardiovascular diseases during pregnancy.
Diagnosing and treating PIH early, when it’s easier to treat, is also important, Dr. Novotny said. Common PIH symptoms you should discuss with your doctor include:
- A headache that doesn’t go away with rest or medication
- Persistent visual disturbances such as floaters or spots in your vision
- Pain in the upper right abdomen
At Kaiser Permanente, when a patient is diagnosed with PIH, a team of specialists will help treat it, Dr. Novotny said. Obstetricians, maternal-fetal medicine specialists, and cardiologists often collaborate on care. In addition to monitoring mom’s and baby’s health, treatment can include medication like low-dose aspirin to help the placenta grow in the healthiest way and reduce the risk for hypertensive issues from the placental hormone during pregnancy. In severe cases, treatment may include delivering the baby early.
If you’re pregnant or looking to become pregnant, or if you have questions or concerns about your individual risk factors and strategies to mitigate those risks, reach out to your care team.
