Treatment of severe persistent hypertension

Emergent treatment of severe acute-onset persistent hypertension (systolic BP > 160 mmHg or diastolic BP > 110 mmHg sustained > 15 minutes) constitutes an important component of high-quality obstetric care. Even in the absence of proteinuria, sudden development of sustained severe hypertension causes significant risk of hemorrhagic stroke and death. An estimated 25% to 45% of maternal strokes occur among patients with preeclampsia, eclampsia or HELLP syndrome.¹ Severe systolic blood pressure is a consistent feature present before the onset of stroke in over 90% of women with hypertensive disorders.²

Related: Hypertensive disorders of pregnancy

References:

• Lanska DJ, Kryscio RJ. Risk factors for peripartum and postpartum stroke and intracranial venous thrombosis. Stroke. 2000;31(6):1274-1282.

• Martin JN, Thigpen BD, Moore RC, Rose CH, Cushman J, May W. Stroke and severe preeclampsia and eclampsia: a paradigm shift focusing on systolic blood pressure. Obstet Gynecol. 2005;105(2):246-254.