Why are they calling this Chronic Hypertension?

[expert on call]

Hi,
I had preeclampsia with my first baby and was induced at 33 weeks. I am now pregnant again and at my 8 week visit my BP was 160/110. Now I am on Aldomet and bedrest. I am confused because my diagnosis is "chronic hypertension", although normally my BP is 120/80 when I am not pregnant. My doctor says that I have a 20% chance of developing preeclampsia with this pregnancy, but I feel like this is already the beginning of it. Can preeclampsia start this early? Why is my condition diagnosed as chronic hypertension? Will my BP continue to rise as my pregnancy progresses?
Thank you,
Lisa Wydra RN

[expert on call]

Women who develop preeclampsia - especially preterm, have an increased risk for the development of chronic hypertension or other cardiovascular disease. Preeclampsia did not create the problem; rather it revealed your tendency, (probably genetic), to be predisposed to cardiovascular disease.

Between pregnancies, you aged a little. You may have gained weight. You may have just advanced in a natural process towards chronic hypertension.

Hypertension at 8 weeks would not be preeclampsia. It is chronic hypertension. The presence of hypertension at this point in pregnancy does represent a risk for the development of preeclampisa. Given how high your blood pressure is, you may need a drug that is more potent than aldomet. There are many safe choices. In our experience, there are women who have a first trimester surge in BP that does calm down to some degree in the second trimester. But, it does come back later. You may benefit from consultation with a specialist in maternal fetal medicine, (www.nasshp.com, www.smfm.org).


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