Hypertension could cause heart failure in postpartum period

According to a recent study, diagnosis of hypertension during pregnancy is associated with an increased risk of maternal cardiovascular disease.

Those with a previous hypertensive disorder are twice at risk. This makes it imperative to monitor blood pressure before discharge and after giving birth, through the postpartum period.

Heart failure, or peripartum cardiomyopathy, can occur up to five months after giving birth. Some symptoms of this condition include tiredness, shortness of breath, swollen ankles, swollen neck veins, and feeling of missed heartbeats or palpitations.

"Hypertension during pregnancy is a major risk factor for both the mother and the baby. High blood pressure can hamper blood flow throughout the body including to the placenta and uterus. This can further affect fetal growth and cause premature detachment of the placenta from the uterus. If not closely monitored before, during, and after childbirth, high blood pressure may even become a major cause of heart problems including heart failure in such women," said Dr Manoj Kumar, Max Balaji Hospital.

Some other fatal repercussions of high blood pressure include pre-term birth, seizures, or even death of the mother and the baby.

The seriousness of peripartum cardiomyopathy can be measured by what is called the ejection fraction. This is the amount of blood that the heart pumps out with each beat. A normal ejection fraction number is about 60 percent.

"Women in the relatively young reproductive age, particularly those with an additional condition such as hypertension are at an increased risk of morbidity and death from heart failure. It is important for them to monitor their blood pressure at regular intervals post childbirth. The risk of heart failure stands true up to five months after giving birth. In case you experience symptoms such as tiredness, shortness of breath, swollen ankles, swollen neck veins, and feeling of missed heartbeats or palpitations, you should contact a specialist at the earliest," said Dr K K Aggarwal, President, Heart Care Foundation of India (HCFI).

High blood pressure is also a major risk factor for the baby and can affect blood flow to the placenta and uterus. This can lead to premature detachment of the placenta from the uterus. It is impossible to reverse the damage caused by heart failure and in some cases, surgery may be needed.

Women should make certain lifestyle changes right from the time they decide to conceive. Some of these include reducing salt intake, exercising regularly, checking the existing medications, getting regular prenatal checkups, and quitting the consumption of tobacco and alcohol.

Dr Manoj Kumar added, "Women diagnosed with high blood pressure postpartum should remain hospitalized for some time. Although the damage caused by heart failure is irreversible, it can still function with the help of some medications and treatment. Heart transplant may be needed in severe cases.

"Women must take steps to bring blood pressure under control from the time they wish to conceive, through certain lifestyle changes."

Some tips to control blood pressure levels before, during, and after pregnancy.

• Know your blood pressure level before getting pregnant.
• High salt, or sodium, intake can raise blood pressure. Aim at eating less salt.
• Get up and get moving before you conceive. Sedentary women are likely to gain weight, which can increase the risk of hypertension during pregnancy, as well as before and after.
• Make sure you are not taking medication that can raise blood pressure levels.
• If you already have high blood pressure, talk to your doctor about the steps that need to be followed.
• Get regular prenatal checkups.
• Tobacco and alcohol are not safe during pregnancy and must be avoided.