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Hypertensive disorders of pregnancy.

Wu, Pensee; Green, Marcus; Myers, Jenny


Marcus Green

Jenny Myers


Hypertensive disorders of pregnancy (HDP) are one of the most commonly occurring complications of pregnancy and include chronic hypertension, gestational hypertension, and pre-eclampsia. New developments in early pregnancy screening to identify women at high risk for pre-eclampsia combined with targeted aspirin prophylaxis could greatly reduce the number of affected pregnancies. Furthermore, recent advances in the diagnosis of pre-eclampsia, such as placental growth factor based testing, have been shown to improve the identification of those pregnancies at highest risk of severe complications. Evidence from trials has refined the target blood pressure and timing of delivery to manage chronic hypertension and pre-eclampsia with non-severe features, respectively. Importantly, a wealth of epidemiological data now links HDP to future cardiovascular disease and diabetes decades after an affected pregnancy. This review discusses the current guidelines and research data on the prevention, diagnosis, management, and postnatal follow-up of HDP. It also discusses the gap in knowledge regarding the long term risks for cardiovascular disease following HDP and illustrates the importance of improving adherence to postnatal guidelines to monitor hypertension and the need for more research focused on primary prevention of future cardiovascular disease in women identified as being at high risk because of HDP. [Abstract copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to]

Journal Article Type Review
Acceptance Date May 25, 2023
Online Publication Date Jun 30, 2023
Publication Date Jun 30, 2023
Deposit Date Jun 30, 2023
Publicly Available Date Jul 1, 2024
Journal BMJ
Print ISSN 0959-8138
Electronic ISSN 0959-8138
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 381
Article Number e071653
Keywords Pregnancy, Cardiovascular Diseases - diagnosis - prevention & control, Pre-Eclampsia - diagnosis - prevention & control, Blood Pressure, Hypertension, Pregnancy-Induced - diagnosis - epidemiology - prevention & control, Female, Placenta Growth Factor, Hum