Topic

Postpartum Hypertension

Hello I'm a 36 year old woman 5'4 110 lbs and overall healthy aside from benign heart palpitations and occasional stress / anxiety. Last year when I was 35 I had a baby (my first) after a normal and healthy pregnancy. I monitored my blood pressure at home during the course of the pregnancy and it was consistently low (80 / 50 - 110 / 70). It was also normal prior to pregnancy and I have no family history of hypertension. During and immediately after delivering the baby my blood pressure was also normal. One week after delivering the baby I developed a headache and my blood pressure was somewhere around 150 / 110. I went to the hospital and there it was lower around 140 / 90. My liver enzymes were elevated by just a few points (10 pts?) and my platelets were normal. I had no proteins in my urine. I was diagnosed with postpartum preeclampsia and sent home with labetalol. The next morning I took a half tab of labetalol (50 mg?) and checked my blood pressure shortly thereafter and it was normal. In follow-up visits at the hospital the following week it was also normal on a very low dose of labetalol. I stopped taking labetalol after a week. A visiting nurse came to check my blood pressure a few days later and it was normal (something like 110/70). About 30 minutes after the nurse left I developed a vision problem that can be described as a crystal in the center of my vision. I panicked and took a tab of labetalol and went to the hospital. There my blood pressure was normal and by that time my vision was normal. The doctor I saw at the hospital pulled up my records which said "atypical HELP syndrome." To summarize the following months my blood pressure remained normal most of the time (off labetalol) but every few weeks I'd get a high reading (or several in one day) such as 130 / 100 or 120 / 95. I'd also have simultaneous days where the diastolic was in the 80's but the systolic was 99 or in the low 100's. Even now almost one year later I'll get a reading of 120 / 90 sometimes although I do see a correlation with stress. Most of the time now it's around 100 / 75. I've been to two internal medicine doctors an obstetrician and a cardiologist but none have been able to answer the following questions: -Do I have chronic hypertension? -If not is it possible to avert chronic hypertension in the future with lifestyle changes? -What is the likelihood that I'll suffer from cardiovascular disease in the near and short term with this history? -Are occasional high readings normal when under stress? Or are high readings bad regardless? Thanks for any insights you can share. I've received conflicting information and I'm confused (and stressed) about my prognosis. Thanks again!

2015-04-10 02:47:26

Amy

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Hi hon: I also had post-partum pre-eclampsia with my one and only pregnancy. It was frightening. I took BP meds for 6 weeks after my baby was born and then my blood pressure came down to normal levels. That was 25 years ago. Since then my BP has been creeping up slowly...and i eat right am not overweight exercise every day etc. However my mother father and all FOUR grandparents had hypertension so I think its just genetics. I take a low dose of Losartan and so far so good. Too answer your questions: Do I have chronic hypertension? I don't know...only a physician can answer this. I had "labile" blood pressure for 25 years...it would go up sometimes down sometimes normal sometimes. I was told that people this often develop hypertension later in life. Truth be told pretty much EVERYONE develops high blood pressure as they age. Our blood vessels harden with the natural aging process and aren't as elastic therefore they can't expand and relax as they once did. -If not is it possible to avert chronic hypertension in the future with lifestyle changes? Maybe. There is "primary" hypertension and "secondary" hypertension. With primary it's genetic and pretty much NO amount of lifestyle change will affect the readings. Secondary hypertension is though to be caused by lifestyle; weight smoking lack of exercise excess salt in your diet stress etc. -What is the likelihood that I'll suffer from cardiovascular disease in the near and short term with this history? This depends on a couple of things: 1. Your family history. Genetics play a huge role in determining when or if we develop heart disease. 2. Exercise. Very very important. Aim for 30 mins of hard cardio at least 3 times a week (provided your doctor is okay with this.) 3. Diet: A plant based diet has been shown to lower the risk of heart attacks. 4. Keep a watch your blood pressure and if it remains elevated take the meds your doctor prescribes. My grandmother lived to almost 90 and took BP meds for most of her life. It doesn't have to kill you or cause strokes as it did 100 years ago...we are very very lucky that there are a variety of medicines that control blood pressure. -Are occasional high readings normal when under stress? Or are high readings bad regardless? Occasional high readings are absolutely normal under stress...in fact if you DIDN'T have a correspondingly high reading during a stressful event. this could be evidence of a problem with your cardiovascular system. The important thing about stressful events is that when they are OVER how quickly does your BP pulse breathing etc return to normal? This is called "recovery rate" and is linked to exercise. I actually chart my heart rate during immediately after and then 2 minutes post exercise (I work out on an elliptical for 30 minutes a day.) You can look up recovery rates on the internet to see what to aim for. Hope this helps...good luck..

2015-04-10 02:48:08

Sun