Some women have high blood pressure during pregnancy. This can put the mother and her baby at risk for problems during the pregnancy. High blood pressure can also cause problems during and after delivery. The good news is that high blood pressure is preventable and treatable.

High blood pressure, also called hypertension, is very common. In the United States, high blood pressure happens in 1 in every 12 to 17 pregnancies among women ages 20 to 44.

High blood pressure in pregnancy has become more common. However, with good blood pressure control, you and your baby are more likely to stay healthy.

The most important thing to do is talk with your health care team about any blood pressure problems so you can get the right treatment and control your blood pressure—before you get pregnant. Getting treatment for high blood pressure is important before, during, and after pregnancy.

In the United States, high blood pressure happens in 1 in every 12 to 17 pregnancies. It’s important to monitor blood pressure before, during, and after pregnancy. High blood pressure during pregnancy can harm a mother’s kidneys and other organs and can cause early birth (called preterm birth) and low birth weight.

Planning for pregnancy

If you are thinking about having a baby and have high blood pressure, talk with your healthcare provider so you can take steps to lower or control your high blood pressure before and during the pregnancy.

Some medicines used to treat high blood pressure are not recommended during pregnancy. If you are taking medicines to lower or control your high blood pressure, talk with your provider about your choices for safely managing high blood pressure while pregnant.

Types of high blood pressure disorders during and after pregnancy

If you have high blood pressure before pregnancy, it will need to be managed during and after pregnancy.

In addition, some women who have a healthy blood pressure develop high blood pressure during or after pregnancy.

• Gestational hypertension is blood pressure greater than or equal to 140/90 that develops during pregnancy. It’s typically diagnosed after 20 weeks of pregnancy or close to delivery.
• Preeclampsia is a combination of high blood pressure during pregnancy and signs that your organs are not working well, such as high protein levels in your urine. This can lead to life-threatening seizures or coma, a condition known as eclampsia. Women who have had preeclampsia have a higher risk of developing high blood pressure and heart disease later in life.
• HELLP syndrome is a more severe type of preeclampsia or eclampsia.
• High blood pressure disorders may continue after the baby is born. Some women may continue to have high blood pressure problems, including preeclampsia, eclampsia, or HELLP syndrome, after the birth of their child, or their high blood pressure may get worse.
• A sudden spike in blood pressure (more than 160/110 mm HG) can also happen during pregnancy or after the baby is born. This is a medical emergency.

Watch for warning signs of a heart problem, including high blood pressure, during and after pregnancy. Some warning signs are a worsening headache, overwhelming tiredness, dizziness, trouble breathing, chest or belly pain, swelling, or nausea. If you feel like something is wrong, get medical care right away.

Managing high blood pressure during pregnancy

As part of your regular prenatal care, your healthcare provider will measure your blood pressure at each visit. Learn more about how to prepare for a blood pressure test.

If you have high blood pressure, you and your baby will be closely monitored so you can receive special care to lower the chance of complications. You may need to:

• Check your blood pressure at home. Visit Measure Your Blood Pressure for more information.
• Keep track of how many times you feel the baby kicking each day.
• Limit your physical activity. Talk to your healthcare provider about what level of physical activity is right for you.
• Take medicine to control your blood pressure. If you do, talk to your provider about which medicines are safe for your baby. These medicines may include calcium-channel blockers (nifedipine) taken by mouth, or beta blockers (labetalol) or vasodilators (hydralazine) through an intravenous (IV) injection.
• Take aspirin in the second trimester,if you are at risk of preeclampsia and your provider recommends aspirin.
• Visit your provider more often to monitor your condition and your baby’s growth rate and heart rate. He or she may order blood and urine tests to check how well your organs are working, which can help detect preeclampsia.

If your healthcare provider is concerned about you or your baby’s health, they may recommend that you deliver your baby before 39 weeks. You may need to stay in the hospital to get medicine that will help your baby’s lungs develop faster and to be monitored before and after you deliver your baby.

Hypertensive disorders of pregnancy are a leading cause of maternal mortality and can put both mother and baby at risk for problems during pregnancy. High blood pressure can also cause problems during and after delivery. Importantly, hypertensive disorders of pregnancy are often preventable and treatable. In the U.S., high blood pressure is noted in one in every 12 to 17 pregnancies among women aged 20 to 44. Hypertensive disorders of pregnancy have become more common, affecting approximately 15% of women during their reproductive years, in part as a result of advanced age at first pregnancy, as well as increasing prevalence of obesity and other cardiometabolic risk factors. There are racial/ethnic disparities in both the burden and outcomes of hypertensive disorders of pregnancy.

Prevention of Hypertensive Disorders of Pregnancy

Lifestyle and behavioral interventions, including optimal maternal weight gain and diet, can improve pregnancy outcomes. Exercise may reduce gestational hypertension and preeclampsia risk by 30% to 40%. Low-dose aspirin started between 12 to 16 weeks of pregnancy can reduce the risk of preeclampsia and related adverse outcomes by 10% to 20% in women at increased risk. Accurate blood pressure measurement is important for diagnosing, classifying, and treating hypertensive disorders of pregnancy. Several self-measured blood pressure devices are accurate in pregnant women, including those with gestational hypertension and preeclampsia.

Treatment

Additional evidence is needed to better define optimal treatment targets and the threshold for pharmacotherapy for hypertensive disorders of pregnancy. Antihypertensive therapy in the setting of hypertensive disorders of pregnancy should focus on the use of safe and effective medications specific to this population. Treatment of hypertension, prevention of seizures, and timed delivery are currently the primary approaches for women with preeclampsia.

Importance of Longitudinal Care

Hypertensive disorders of pregnancy can lead to complications during and after delivery as well as life-long risk and early onset of CVD. Therefore, postpartum assessment and control of cardiovascular risk factors is essential in those with hypertensive disorders of pregnancy. A team-based approach and multi-specialty collaboration is needed to ensure appropriate care transition with the goal of optimizing cardiovascular preventive strategies across the life course.

Your doctor or nurse should look for these conditions before, during, and after pregnancy:

Chronic Hypertension

Chronic hypertension means having high blood pressure before you get pregnant or before 20 weeks of pregnancy. Women who have chronic hypertension can also get preeclampsia in the second or third trimester of pregnancy.

Gestational Hypertension

This condition happens when you only have high blood pressure during pregnancy and do not have protein in your urine or other heart or kidney problems. It is typically diagnosed after 20 weeks of pregnancy or close to delivery. Gestational hypertension usually goes away after you give birth. However, some women with gestational hypertension have a higher risk of developing chronic hypertension in the future.

Preeclampsia/Eclampsia

Preeclampsia happens when a woman who previously had normal blood pressure suddenly develops high blood pressure and protein in her urine or other problems after 20 weeks of pregnancy. Women who have chronic hypertension can also get preeclampsia.

Preeclampsia happens in about 1 in 25 pregnancies in the United States. Some women with preeclampsia can develop seizures. This is called eclampsia, which is a medical emergency.

Symptoms of preeclampsia include:

• A headache that will not go away
• Changes in vision, including blurry vision, seeing spots, or having changes in eyesight
• Pain in the upper stomach area
• Nausea or vomiting
• Swelling of the face or hands
• Sudden weight gain
• Trouble breathing

Some women have no symptoms of preeclampsia, which is why it is important to visit your health care team regularly, especially during pregnancy.

You are more at risk for preeclampsia if:

• This is the first time you have given birth.
• You had preeclampsia during a previous pregnancy.
• You have chronic (long-term) high blood pressure, chronic kidney disease, or both.
• You have a history of thrombophilia (a condition that increases risk of blood clots).
• You are pregnant with multiple babies (such as twins or triplets).
• You became pregnant using in vitro fertilization.
• You have a family history of preeclampsia.
• You have type 1 or type 2 diabetes.
• You have obesity.
• You have lupus (an autoimmune disease).
• You are older than 40.

In rare cases, preeclampsia can happen after you have given birth. This is a serious medical condition known as postpartum preeclampsia. It can happen in women without any history of preeclampsia during pregnancy. The symptoms for postpartum preeclampsia are similar to the symptoms of preeclampsia. Postpartum preeclampsia is typically diagnosed within 48 hours after delivery but can happen up to 6 weeks later.

Tell your health care provider or call 9-1-1 right away if you have symptoms of postpartum preeclampsia. You might need emergency medical care.

Complications from high blood pressure for the mother and infant can include the following:

• For the mother: preeclampsia, eclampsia, stroke, the need for labor induction (giving medicine to start labor to give birth), and placental abruption (the placenta separating from the wall of the uterus).
• For the baby: preterm delivery (birth that happens before 37 weeks of pregnancy) and low birth weight (when a baby is born weighing less than 5 pounds, 8 ounces). The mother’s high blood pressure makes it more difficult for the baby to get enough oxygen and nutrients to grow, so the mother may have to deliver the baby early.

Measure your blood pressure regularly to help your health care team diagnose any health problems early. You and your health care team can take steps to control your blood pressure if it is too high.

Why do I need to measure my blood pressure?

Measuring your blood pressure is the only way to know whether you have high blood pressure. High blood pressure usually has no warning signs or symptoms, and many people do not know they have it.

Where can I get my blood pressure checked?

You can get your blood pressure measured

• By a health care team member at a doctor’s office.
• At a pharmacy that has a digital blood pressure measurement machine.
• With a home blood pressure monitor that you can use yourself.

What affects a blood pressure reading?

Many things can affect a blood pressure reading, including:

• Nervousness about having your blood pressure taken. This is called “white coat syndrome.” As many as 1 in 3 people who have a high blood pressure reading at the doctor’s office may have normal blood pressure readings outside of it.
• What you ate, drank, or did before your reading. If you smoked, drank alcohol or caffeine, or exercised within 30 minutes of having your blood pressure measured, your reading might be higher.
• How you are sitting. Crossing your legs and letting your arm droop at your side rather than rest on a table at chest height can make your blood pressure go up.

It’s important to get an accurate blood pressure reading so that you have a clearer picture of your risk for heart disease and stroke.

A reading that says your blood pressure is lower than it actually is may give you a false sense of security about your health. A reading that says your blood pressure is higher than it actually is may lead to treatment you don’t need.

What is the correct way to measure blood pressure?

Learn the correct way to have your blood pressure taken, whether you’re getting it checked at the doctor’s office or checking it yourself at home. Use this checklist:

• Don’t eat or drink anything 30 minutes before you take your blood pressure.
• Empty your bladder before your reading.
• Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
• Put both feet flat on the ground and keep your legs uncrossed.
• Rest your arm with the cuff on a table at chest height.
• Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
• Do not talk while your blood pressure is being measured.

How do health care professionals measure my blood pressure?

First, a health care professional wraps an inflatable cuff around your arm. The health care professional then inflates the cuff, which gently tightens on your arm. The cuff has a gauge on it that will measure your blood pressure.

The health care professional will slowly let air out of the cuff while listening to your pulse with a stethoscope and watching the gauge. This process is quick and painless. If using a digital or automatic blood pressure cuff, the healthcare professional will not need to use a stethoscope.

The gauge uses a unit of measurement called millimeters of mercury (mmHg) to measure the pressure in your blood vessels. Learn more about blood pressure measurements.

If you have high blood pressure, talk to your healthcare team about steps to take to control your blood pressure to lower your risk for heart disease and stroke.

How can I measure my blood pressure at home?

Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure (SMBP) monitoring.

SMBP means you regularly use a personal blood pressure measurement device away from a doctor’s office or hospital—usually at home. These blood pressure monitors are easy and safe to use. A health care team member can show you how to use one if you need help.

Evidence shows that people with high blood pressure are more likely to lower their blood pressure if they use SMBP combined with support from their health care team than if they don’t use SMBP.

Use these additional tips for SMBP:

• Use a blood pressure log to record your blood pressure measurements.
• Take your blood pressure at the same time every day.
• Take at least two readings, 1 or 2 minutes apart.

How often should I measure my blood pressure?

Talk with your health care team about how often you should have your blood pressure measured or when to measure it yourself. People who have high blood pressure may need to measure their blood pressure more often than people who do not have high blood pressure.

What should I do if my blood pressure numbers are high?

If you are concerned about your blood pressure numbers, talk to your health care team. They can help you make a plan to manage high blood pressure.

No matter your age, you also can take steps each day to help keep your blood pressure in a healthy range.

Before Pregnancy

• Make a plan for pregnancy and talk with your doctor or health care team about the following:
  • Any health problems you have or had and any medicines you are taking. If you are planning to become pregnant, talk to your doctor. Your doctor or health care team can help you find medicines that are safe to take during pregnancy.
  • Ways to keep a healthy weight through healthy eating and regular physical activity.

During Pregnancy

• Get early and regular prenatal care. Go to every appointment with your doctor or health care professional.
• Talk to your doctor about any medicines you take and which ones are safe. Do not stop or start taking any type of medicine, including over-the-counter medicines, without first talking with your doctor.
• Keep track of your blood pressure at home with a home blood pressure monitor. Contact your doctor if your blood pressure is higher than usual or if you have symptoms of preeclampsia. Talk to your doctor or insurance company about getting a home monitor.
• Continue to choose healthy foods and keep a healthy weight.

After Pregnancy

• Pay attention to how you feel after you give birth. If you had high blood pressure during pregnancy, you have a higher risk for stroke and other problems after delivery. Tell your doctor or call 9-1-1 right away if you have symptoms of preeclampsia after delivery. You might need emergency medical care.

Credit: Journal of the American College of Cardiology

High blood pressure, an all-too-common feature of pregnancy, appears to carry risks for a woman’s cardiovascular health months or years after giving birth, and even shorten her life span. 

The researchers found that pregnant women who experienced either gestational hypertension or preeclampsia, known as hypertensive disorders of pregnancy, have a greater risk of premature death from cardiovascular disease, which includes heart disease and stroke. This was the case even if the women did not develop chronic hypertension.  

The study was based on data from more than 88,000 women who had at least one pregnancy and participate in the Nurses’ Health Study II. During 28 years of follow-up, 2,387 died prematurely – any death before age 70 – including 212 from cardiovascular diseases. The researchers found that having had gestational hypertension or preeclampsia was associated with a 42% increase in premature mortality. 

By living a healthy lifestyle, you can help keep your blood pressure in a healthy range. Preventing high blood pressure, which is also called hypertension, can lower your risk for heart disease and stroke. Practice the following healthy living habits:

Eat a Healthy Diet

Choose healthy meal and snack options to help you avoid high blood pressure and its complications. Be sure to eat plenty of fresh fruits and vegetables.

Talk with your health care team about eating a variety of foods rich in potassium, fiber, and protein and lower in salt (sodium) and saturated fat. For many people, making these healthy changes can help keep blood pressure low and protect against heart disease and stroke.

The DASH (Dietary Approaches to Stop Hypertension) eating plan is a healthy diet plan with a proven record of helping people lower their blood pressure.

Keep Yourself at a Healthy Weight

Having overweight or obesity increases your risk for high blood pressure. To determine whether your weight is in a healthy range, doctors often calculate your body mass index (BMI). If you know your weight and height, you can calculate your BMI at CDC’s Assessing Your Weight website. Doctors sometimes also use waist and hip measurements to assess body fat.

Talk with your health care team about ways to reach a healthy weight, including choosing healthy foods and getting regular physical activity.

Be Physically Active

Physical activity can help keep you at a healthy weight and lower your blood pressure. The Physical Activity Guidelines for Americans recommends that adults get at least 2 hours and 30 minutes of moderate-intensity exercise, such as brisk walking or bicycling, every week. That’s about 30 minutes a day, 5 days a week. Children and adolescents should get 1 hour of physical activity every day.

Do Not Smoke

Smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, do not start. If you do smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you quit.

For more information about tobacco use and quitting, see CDC’s Smoking and Tobacco Use Web site.

Limit How Much Alcohol You Drink

Do not drink too much alcohol, which can raise your blood pressure. Men should have no more than 2 alcoholic drinks per day, and women should have no more than 1 alcoholic drink per day. Visit the CDC’s Alcohol and Public Health website for more information.

Get Enough Sleep

Getting enough sleep is important to your overall health, and enough sleep is part of keeping your heart and blood vessels healthy. Not getting enough sleep on a regular basis is linked to an increased risk of heart disease, high blood pressure, and stroke.