How to Maintain Hypertension During Pregnancy

 Hypertension during pregnancy increases the likelihood of harm to mother and baby, including a higher lifetime risk of heart disease and stroke. Most pregnancy-related deaths stemming from hypertension are preventable, however.

Identifying a physician who’s responsible for continuity of care ensures timely diagnosis and treatment of hypertension during pregnancy, which happens in about 16% of hospital deliveries. The AMA is collaborating with other organizations on quality improvement guidance to help clinicians optimize care for patients with this condition.

The “Hypertension in Pregnancy Change Package,” which was developed by the Centers for Disease Control and Prevention (CDC), offers a variety of evidence-informed implementation strategies and corresponding tools practices can use to better diagnose and manage this condition during pregnancy and the postpartum period.

The change package includes tools and resources for any physician or health professional who cares for people who are pregnant or in the postpartum period. This includes: ob-gyns, family doctors, internists, cardiologists, endocrinologists, emergency physicians, nurses, medical assistants, nurse practitioners, physician assistants and pharmacists.

Michael Rakotz, MD, a family physician who is the AMA’s group vice president for improving health outcomes, said the Association supports key strategies that the change package covers. These include:

  1. The diagnosis and treatment of hypertension.
  2. The prophylactic use of aspirin to reduce preeclampsia and related complications.
  3. The use of self-measured blood pressure monitoring that can help individuals and their care teams detect and manage hypertension in a timely way.
  4. Postpartum counseling on long-term cardiovascular risk.

Women need counseling on the importance of getting follow-up care after giving birth. MTP Kit.  Rates of follow-up visits after delivery are historically low, however, resulting in missed opportunities to identify and address cardiovascular risk.

“It is important to incorporate strategies for postpartum-risk counseling and continued long-term monitoring of women with conditions that arise during pregnancy, including hypertension,” Dr. Rakotz said.

The AMA has a long history of supporting hypertension management in primary care settings. AMA MAP™ Hypertension is an evidence-based quality improvement program that provides a clear path to significant, sustained improvements in BP control. With the AMA MAP program, health care organizations can increase BP-control rates quickly. The program has demonstrated a 10% increase in BP control in six months with sustained results at one year in primary care settings.

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