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Will my blood pressure medication change during pregnancy?
It could. Some drugs for high blood pressure aren't safe to take during pregnancy, so your healthcare provider may prescribe a different medication than what you took before.
It also depends on a number of other factors, including what medication you've been taking (if any) and how severe your condition is. For most women, the goal during pregnancy is to keep blood pressure around 140 to 150 systolic millimeters of mercury (mmHg) and 90 to 100 diastolic mmHg.
Blood pressure often drops naturally early in pregnancy. If it drops to normal levels (less than 140/90) and you don't have any other health problems, your provider may have you stop taking the medication you usually take.
If your provider advises you to stop taking medication, you'll be monitored closely. And if your blood pressure begins to rise as your pregnancy progresses, it's likely that she'll recommend restarting it.
Don't stop or change medication without consulting your provider first. Uncontrolled high blood pressure is bad for you and your baby.
If your blood pressure is persistently high (over 160 mmHg or 105 mmHg) and you're not taking medication to control it, your provider will prescribe one. If you're already taking medication and your blood pressure still is high, then your provider may adjust the dose or add a different medication.
Medication to reduce and stabilize blood pressure is usually taken orally. However, if your blood pressure gets too high or doesn't respond to medication, you may need to go to a hospital to be given medication intravenously.
Having chronic high blood pressure puts you at a higher risk of getting preeclampsia, so your provider may suggest you take a low dose of aspirin, beginning at the end of the first trimester. Aspirin can help reduce the risk of preeclampsia.
Is blood pressure medication safe to take when I'm pregnant?
Some high blood pressure medications are considered safe, and some aren't.
Drugs considered safe
Many drugs used to treat high blood pressure are considered safe because they haven't been shown to cause birth defects. But medication to control blood pressure may cross the placenta, which means that some amount can reach your baby.
Even drugs that are considered safe can still reduce blood flow to the placenta and to your baby. This could slow down your baby's growth or put him at risk of other health problems. You'll most likely have additional ultrasounds so your provider can monitor your baby's development.
Also, while you're pregnant, your provider will try to control your blood pressure with the minimum amount of medication. If your provider thinks you need a drug and there's any concern about its safety, the drug will be prescribed at the lowest effective dose.
Drugs considered unsafe
Some types of blood pressure medications shouldn't be used during pregnancy. Drugs known to put babies at risk of kidney issues, birth defects, and other health problems include:
- ACE inhibitors (angiotensin-converting-enzyme inhibitors)
- ARBs (angiotensin receptor blockers)
- Direct renin inhibitors
If your pregnancy was planned, your provider probably has already switched you to another medication. But if your pregnancy was unplanned, or if you're unsure whether your medication is safe, call your provider right away. Don't stop or change your medication without consulting your provider first.
How do I handle my worries about taking blood pressure medication during pregnancy?
The first step toward coping with your fears is talking to your provider about the type of medication you're taking. If she hasn't already, ask her to explain the risks associated with the medication and how it compares with alternative treatments.
Your provider will help you balance the risks and benefits for you and your baby. Together you can come up with a plan to manage your blood pressure.
It's important to remember that not taking medication has serious risks too. Uncontrolled high blood pressure can prevent your baby from growing well and, in extreme cases, puts you at risk of organ damage or a stroke.
If you have to take medication, focus on the other choices you can make to keep you and your baby healthy. Eat nutritious food, gain a healthy amount of weight during pregnancy, and get regular exercise (after your provider gives you the go-ahead).
Visit the Society for Maternal-Fetal Medicine's website for more information and to find an MFM specialist near you.