ACC CardiaCast PulseCheck: High Blood Pressure, High Stakes: Pregnancy and Hypertension
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Nov 8, 2025 Kismet Rasmusson, a seasoned nurse practitioner and clinical research professor, joins Malamo Countouris, a cardiology professor specializing in women's cardiovascular health. They dive into the critical issues of hypertensive disorders during pregnancy and postpartum. The conversation highlights long-term cardiovascular risks for women post-pregnancy and effective monitoring strategies. They discuss implementing clinical pathways to address care gaps and the importance of team roles in enhancing patient outcomes in cardio-obstetrics.
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Scope And Consequences Of Pregnancy Hypertension
- Hypertensive disorders of pregnancy include chronic hypertension, gestational hypertension, preeclampsia, and eclampsia and are defined by elevated blood pressure in pregnancy.
- They complicate 10–20% of pregnancies and increase maternal and fetal risks including preterm delivery, fetal growth restriction, stroke, pulmonary edema, and heart failure.
Pregnancy Hypertension Predicts Future Heart Risk
- Hypertensive disorders during pregnancy raise long-term cardiovascular risk including hypertension, myocardial infarction, heart failure, stroke, and peripheral arterial disease.
- Risks increase with disorder severity and can manifest within five years or later, prompting structured long-term surveillance.
Implement Structured Postpartum Screening
- Screen patients early and repeatedly after delivery for blood pressure and cardiovascular risk factors using timelines like within 12 weeks to one year postpartum.
- Apply risk-reduction strategies from Life's Essential Eight: blood sugar, BP, cholesterol, smoking, weight, exercise, diet, and sleep.