New with questions about HBP and pregnancy

[sunny8168]

I am 35 (and overweight)and my husband and I have just decided to TTC#1. I am on BP medication (Toprol Xl 100mg/day and 81mg asprin)after a sudden rise in blood pressure last January (about 160/94). I had had some elevated reading in the past and a paternal family history of HBP. He has diagnosed me with benign hypertension. The meds seem to be helping. I am very excited to get pregnant but also really scared after reading some of the stories on these and other boards. My doctor said it is okay to get pregnant on the medication I am currently taking. Am I more likely to get pre-e due to my history of HBP? Will the medication harm a baby or will it help? I hate the thought of doing anything to cause harm to a baby we may conceive but can't deal with not having children either. Any thoughts would be helpful and much appreciated. Thanks!

Sunny

[expert on call]

A 35 year old with easily controlled hypertension should have a successful pregnancy outcome statistically approaching the odds for normotensive women. However there is a 20-25% chance of developing superimposed preeclampsia. In most the complication will occur near term, but a few will experience severe disease and thus patients with essential hypertension should have their gestations managed by physicians who specialize in high risk obstetrics and preferably delivery at a tertiary center with a specialized nursery for very premature infants (for the very few who develop early superimposed preeclampsia).

Concerning anti-hypertensive therapy: The two recommended drugs with the largest reported experience of use in pregnant women are methyl dopa (aldomet) and labetalol (normodyne). The former is unique for a study that followed the newborn for 7.5 years. Many physicians prefer not to use pure beta blocking agents such as toprol, as such drugs are reported to be associated with smaller babies or even growth retardation. However at least one group takes an opposite opinion claiming beta blockers (particularly atenolol) reduces the incidence of preeclampsia.

In summary: the prognosis for the patient is good in the hands of a high risk specialist

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