By Rachel Grumman Bender
At my last prenatal checkup three years ago, just six days shy of my scheduled C-section, my obstetrician discovered that my blood pressure had suddenly shot up. I had preeclampsia, a cardiovascular condition that affects up to 8 percent of pregnant women each year in the United States, according to the Preeclampsia Foundation.
My doctor said there was no time to waste. He sent me to the hospital that day for an emergency C-section, at 37 weeks, to deliver my twins. Postbirth, I was put on a magnesium sulfate IV drip for 24 hours so I wouldn’t have a seizure.
I’d heard about preeclampsia before, and that when you give birth, your blood pressure goes back down — sometimes with the help of a temporary blood pressure medication, which I was also put on for a couple of months. I was told that eventually, my blood pressure would return to normal. Except it didn’t.
Even though my blood pressure was normal (120/80) pre-pregnancy and excellent (110/70) during the majority of my pregnancy, it has remained high since I gave birth. Despite the fact that I lost what little pregnancy weight I’d gained, exercise regularly, eat right, and don’t smoke, my primary care physician said I may need to go on blood pressure medication — 20 years earlier than my parents had to.
“We’ve said for many years that delivery is the cure,” says Maurice Druzin, M.D., professor of obstetrics, gynecology, and maternal fetal medicine at Lucile Packard Children’s Hospital Stanford, in Palo Alto, California. Dr. Druzin tells Parents: “The true statement is, delivery is the most important intervention toward curing the disease of preeclampsia. If you don’t deliver, it’s not going to get better. However, the profound effects of preeclampsia on all organ systems may take up to six weeks after delivery to completely resolve.”
In fact, Dr. Druzin points out that in most cases, the disease resolves itself after childbirth. But for some women, the residual high blood pressure can take up to two years to go away, says Ellen W. Seely, M.D., professor of medicine at Harvard Medical School and director of clinical research in the endocrinology, diabetes, and hypertension division at Brigham and Women’s Hospital in Boston. For others, like me, the effects are even longer lasting. “We’ve seen cases of patients who get better, but still have residual hypertension,” says Dr. Druzin. “Those patients do not have preeclampsia, which only occurs in pregnancy and for up to six weeks postpartum. The correct diagnosis would be chronic hypertension.”
The jury’s still out on what exactly causes preeclampsia. “The most accepted explanation is a problem with the placenta, which produces substances that cause the clinical condition that we call preeclampsia,” says Dr. Druzin. A 2014 study suggests that the condition may be brought on by insufficient oxygen to the fetus. What experts do know is that preeclampsia is characterized by vasospasm (abnormal constriction of blood vessels). It is more common with first-time pregnancies, as well as in women who are carrying multiples, are over 40, are obese, or have a personal or family history of the condition, according to the Mayo Clinic.
Your genetic makeup may also play a role. “We think that preeclampsia actually is a marker for a patient whose vasculature, or arrangement of blood vessels, is pre-destined to have some abnormality,” explains Dr. Druzin.
Regardless of the possible causes, having preeclampsia can have a lasting effect on your health. “Over the past 10 years or so, we have [had] an increasing amount of data that show women who have had preeclampsia are at increased risk for hypertension, heart disease, and stroke,” Dr. Seely says. There is also data indicating that preeclampsia increases future risk for Type 2 diabetes, she says.
In fact, the condition doubles your risk of stroke and quadruples your risk of high blood pressure later in the life, according to the American Heart Association, making it all the more important that women who have preeclampsia are carefully monitored by their primary care providers. But experts say that many women and some clinicians don’t know about the long-term health risks that can come from what many consider to be a temporary condition.
“We found that women are often not aware that their history of preeclampsia gives them an increased likelihood of developing future high blood pressure, heart disease, and stroke,” says Dr. Seely. “Unless they’re aware, they’re not going to think they’re a candidate to adopt lifestyle modifications. A lot of health providers are also not aware of the association, so women aren’t given the information or the tools by which they could decrease their risk.”
If you’ve had preeclampsia, let your primary care provider know and get regular checkups to monitor your blood pressure, cholesterol, and blood sugar. Although Dr. Seely notes that more research is needed to find out whether women who have had preeclampsia require more individualized treatments, it doesn’t hurt to adopt the same healthy behaviors as would anyone trying to lower her cardiovascular disease risk: Get to or maintain a healthy weight, exercise regularly, stop smoking, and follow a healthy diet, such as the DASH diet, which has been clinically proven to lower blood pressure.