How to Reduce High Blood Pressure During Pregnancy (Without Losing Your Mind)

Pregnancy can be an equally joyful and stressful time: There’s the excitement of welcoming a cuddly new baby into your life, and, of course, the relentless planning that comes with it. The last thing anyone needs during this period is one more thing to worry about, but sometimes, extra stress is unavoidable.

Like, say, finding out during your latest prenatal care visit that you have high blood pressure.

High blood pressure, or hypertension, occurs when the heart has to work harder to pump blood because the force of the blood pushing against the artery walls is too high. It’s a common condition that can be treated with medication and/or healthy lifestyle habits (eating well, exercising, and not smoking). If left untreated, hypertension can increase the risk of heart attack, stroke, and other serious health problems.

High blood pressure on its own sounds scary enough, but what happens when you add pregnancy to the mix? 

Rescripted spoke with Dorothy Bestoyong, DO, an OB/GYN based in Orlando, Florida, to help readers understand what a hypertension diagnosis means for pregnant people, and how they can best prevent and reduce their high blood pressure. 

What does high blood pressure in pregnancy look like?

Any reading at or above 140/90 is considered high blood pressure in pregnancy, says Dr. Bestoyong. The top number measures systolic pressure, or the force the heart produces when it pumps blood out to the body. The bottom number measures diastolic pressure, or the pressure in your blood vessels when the heart is at rest. A normal, non-pregnancy blood pressure reading is 120/80.

Possible risk factors for pregnancy hypertension include obesity, diabetes, hypertension prior to pregnancy, certain pre-existing conditions like autoimmune diseases, advanced maternal age (35 or older), first-time pregnancy, carrying twins or more, high cholesterol levels, and a family history of high blood pressure in pregnancy. 

According to Dr. Bestoyong, three types of hypertension could present in pregnancy: 

• Chronic hypertension: In this case, the patient already had high blood pressure before pregnancy. Or, the high blood pressure developed during the first 20 weeks of pregnancy.

• Gestational hypertension: This is when high blood pressure develops after 20 weeks of pregnancy without protein in the urine and there are no signs of organ damage. Gestational hypertension can lead to preeclampsia in some cases.

• Preeclampsia: Preeclampsia occurs when the patient has high blood pressure 20 weeks after pregnancy and has protein in the urine. This is a serious condition associated with signs of damage to other organs, including the kidneys, liver, blood, or brain. 

While some with hypertension do notice an increase in swelling or headaches, high blood pressure doesn’t always present with symptoms. The best way to find out if you’re experiencing this condition is to have your blood pressure measured during your regular prenatal visits. 

Even if you’re not experiencing symptoms, your high blood pressure must be taken seriously. Dr. Bestoyong warns that hypertension during pregnancy could cause a host of problems, including placental abruption. This complication occurs when the placenta — which provides oxygen and nutrients to the baby — partly or completely separates from the inner wall of the uterus before delivery. Fetal demise can sometimes result from placental abruption. Additional pregnancy complications from high blood pressure include preterm labor, maternal stroke, hemorrhage, eclampsia, and seizures.

Can you reduce high blood pressure during pregnancy?

Managing and reducing your pregnancy hypertension will depend on the type and cause of your high blood pressure so it’s important to ask your healthcare provider for guidance. 

“In general, eating a well-rounded diet, decreasing salt, and incorporating heart-healthy exercise will help prevent high blood pressure,” says Dr. Bestoyong. These lifestyle habits will also help with a healthier pregnancy overall.

For patients who have hypertension risk factors, it “may be recommended that they take 81mg of aspirin daily starting at 12 weeks until 36 weeks of pregnancy,” says Dr. Bestoyong. “This has been shown to decrease risks of preeclampsia.”

Depending on your case, your healthcare provider may prescribe blood pressure medication to help lower your readings. 

If you’ve been diagnosed with gestational hypertension or pre-eclampsia, however, you must make a plan with your physician. “It is really important to discuss with your OB/GYN whether you will need additional monitoring,” says Dr. Bestoyong.

Hypertension in pregnancy: Management and prevention

Rather than trying to reduce your blood pressure during pregnancy — when you’re likely pretty stressed already — prevention is your best course of action. 

Adopt healthy habits before getting pregnant like eating a diet rich in fruits, vegetables, and protein, exercising regularly, quitting smoking, managing stress, and maintaining a healthy weight.

If you are diagnosed with hypertension in pregnancy and aren’t exhibiting symptoms, your healthcare provider will monitor your blood pressure during your prenatal visits. Dr. Bestoyong says additional blood pressure checks aren’t necessary as long as you receive them at your doctor’s appointments. 

However, if your physician “identifies symptoms or abnormal readings, [patients] may be recommended they monitor their blood pressure twice daily after sitting/laying still for about five to 10 minutes,” says Dr. Bestoyong.

While Dr. Bestoyong does acknowledge that “stress and anxiety can contribute to abnormal readings, severely elevated blood pressure should not be overlooked as due to stress or anxiety.” No doubt dealing with a condition like hypertension in pregnancy can increase your stress levels, but if your at-home readings are above normal (like 160/110), contact your doctor ASAP.

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Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Subscribe to her Substack, the Critical Communicator, and follow her on Instagram, BlueSky, or Threads.