Lower Thresholds Could ID Hypertension in More Pregnant Women
Reclassification of hypertension status could also identify more women at risk for preeclampsia, adverse fetal/neonatal events
THURSDAY, April 1, 2021 (HealthDay News) -- Use of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guideline definition of hypertension would increase the prevalence of chronic and gestational hypertension among pregnant women and identify more women who would go on to develop preeclampsia, according to a study published online March 31 in JAMA Network Open.
Natalie A. Bello, M.D., M.P.H., from the Columbia University Irving Medical Center in New York City, and colleagues used electronic medical record data for women who delivered singleton infants between 2009 and 2014 to examine whether reclassification of hypertensive status using the ACC/AHA guideline definition better identifies women at risk for preeclampsia or eclampsia compared with the current American College of Obstetricians and Gynecologists hypertension definition.
The researchers found that applying the ACC/AHA criteria to 137,389 pregnancies of women resulted in a 14.3 and 13.8 percent prevalence of chronic hypertension and gestational hypertension, respectively. There was a 17.8 percent absolute increase in the overall prevalence of hypertension, from 10.3 to 28.1 percent. Compared with women without hypertension by either criterion, the 2.1 percent of women who were reclassified with chronic rather than gestational hypertension had the highest risk for developing preeclampsia (adjusted risk ratio, 13.58). An improvement of 20.8 percent was seen in the appropriate identification of future preeclampsia with use of the ACC/AHA criteria to diagnose hypertension, while an improvement of 3.8 percent was seen in appropriate fetal/neonatal risk classification.
"Reclassification also markedly improved the appropriate identification of maternal risk for preeclampsia and, to a lesser extent, identified women with heightened fetal/neonatal risk as well," the authors write.
Two authors disclosed financial ties to the pharmaceutical, publishing, and other industries.