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Prevention, Diagnosis, and Management of Hypertensive Disorders of Pregnancy: a Comparison of International Guidelines.
Curr Hypertens Rep. 2020 08 27; 22(9):66.CH

Abstract

PURPOSE OF REVIEW

Hypertensive disorders of pregnancy (HDP)-gestational hypertension, preeclampsia, and eclampsia-are a leading cause of adverse maternal and perinatal outcomes internationally. Prevention, timely diagnosis, and prompt management can reduce associated morbidity. The purpose of this review is to compare international guidelines pertaining to HDP.

RECENT FINDINGS

Fourteen HDP guidelines were compared relative to guidelines for the United States (US) where the authors practice. Aspirin is universally recommended for high-risk women to reduce preeclampsia risk. Recommended dose and gestational age at initiation vary. Diagnoses of chronic hypertension, gestational hypertension, and preeclampsia in pregnant women are similar, although blood pressure (BP) thresholds for antihypertensive medication initiation and treatment targets vary due to the limitations in high-quality evidence. There are differences among international HDP guidelines related to dose and timing of aspirin initiation, thresholds for antihypertensive medication initiation, and BP targets. However, all guidelines acknowledge the significant morbidity associated with HDP and advocate for timely diagnosis and management to reduce associated morbidity and mortality. More research is needed to understand optimal BP thresholds at which to initiate antihypertensive medication regimens and BP targets in pregnancy.

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Authors+Show Affiliations

Sinkey RG
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, 1700 6th Avenue South, 176F Suite 10270, Birmingham, AL, 35249, USA. rsinkey@uabmc.edu. Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA. rsinkey@uabmc.edu.
Battarbee AN
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, 1700 6th Avenue South, 176F Suite 10270, Birmingham, AL, 35249, USA. Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Bello NA
Department of Medicine, Division of Cardiology, Columbia College of Physicians and Surgeons, New York, NY, USA.
Ives CW
Tinsley Harrison Internal Medicine Residency Program, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Oparil S
Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
Tita ATN
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, 1700 6th Avenue South, 176F Suite 10270, Birmingham, AL, 35249, USA. Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.

MeSH

Antihypertensive AgentsBlood PressureEclampsiaFemaleHumansHypertension, Pregnancy-InducedPre-EclampsiaPregnancy

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Review

Language

eng

PubMed ID

32852691

Citation

Sinkey, Rachel G., et al. "Prevention, Diagnosis, and Management of Hypertensive Disorders of Pregnancy: a Comparison of International Guidelines." Current Hypertension Reports, vol. 22, no. 9, 2020, p. 66.
Sinkey RG, Battarbee AN, Bello NA, et al. Prevention, Diagnosis, and Management of Hypertensive Disorders of Pregnancy: a Comparison of International Guidelines. Curr Hypertens Rep. 2020;22(9):66.
Sinkey, R. G., Battarbee, A. N., Bello, N. A., Ives, C. W., Oparil, S., & Tita, A. T. N. (2020). Prevention, Diagnosis, and Management of Hypertensive Disorders of Pregnancy: a Comparison of International Guidelines. Current Hypertension Reports, 22(9), 66. https://doi.org/10.1007/s11906-020-01082-w
Sinkey RG, et al. Prevention, Diagnosis, and Management of Hypertensive Disorders of Pregnancy: a Comparison of International Guidelines. Curr Hypertens Rep. 2020 08 27;22(9):66. PubMed PMID: 32852691.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention, Diagnosis, and Management of Hypertensive Disorders of Pregnancy: a Comparison of International Guidelines. AU - Sinkey,Rachel G, AU - Battarbee,Ashley N, AU - Bello,Natalie A, AU - Ives,Christopher W, AU - Oparil,Suzanne, AU - Tita,Alan T N, Y1 - 2020/08/27/ PY - 2020/8/28/entrez PY - 2020/8/28/pubmed PY - 2021/3/12/medline KW - Chronic hypertension KW - Eclampsia KW - Gestational hypertension KW - Guidelines KW - Hypertensive disorders of pregnancy KW - Preeclampsia SP - 66 EP - 66 JF - Current hypertension reports JO - Curr Hypertens Rep VL - 22 IS - 9 N2 - PURPOSE OF REVIEW: Hypertensive disorders of pregnancy (HDP)-gestational hypertension, preeclampsia, and eclampsia-are a leading cause of adverse maternal and perinatal outcomes internationally. Prevention, timely diagnosis, and prompt management can reduce associated morbidity. The purpose of this review is to compare international guidelines pertaining to HDP. RECENT FINDINGS: Fourteen HDP guidelines were compared relative to guidelines for the United States (US) where the authors practice. Aspirin is universally recommended for high-risk women to reduce preeclampsia risk. Recommended dose and gestational age at initiation vary. Diagnoses of chronic hypertension, gestational hypertension, and preeclampsia in pregnant women are similar, although blood pressure (BP) thresholds for antihypertensive medication initiation and treatment targets vary due to the limitations in high-quality evidence. There are differences among international HDP guidelines related to dose and timing of aspirin initiation, thresholds for antihypertensive medication initiation, and BP targets. However, all guidelines acknowledge the significant morbidity associated with HDP and advocate for timely diagnosis and management to reduce associated morbidity and mortality. More research is needed to understand optimal BP thresholds at which to initiate antihypertensive medication regimens and BP targets in pregnancy. SN - 1534-3111 UR - https://www.unboundmedicine.com/medline/citation/32852691/Prevention_Diagnosis_and_Management_of_Hypertensive_Disorders_of_Pregnancy:_a_Comparison_of_International_Guidelines_ DB - PRIME DP - Unbound Medicine ER -