重视孕期轻度高血压的管理

On management of mild hypertension during pregnancy

孕妇血压≥160/110 mmHg(1 mmHg=0.133 kPa)时进行降压治疗已成为共识,但对于血压<160/110 mmHg的轻度高血压孕妇是否需要降压治疗目前各国建议仍不一致。我国指南推荐血压≥140/90 mmHg的孕妇需要采取降压治疗。近期一项研究发现,血压≥140/90 mmHg的孕妇接受降压治疗,能进一步改善妊娠结局,为我国指南推荐提供了证据支持。同时,目前有研究表明血压130~139/80~89 mmHg的“正常高值血压”孕妇不良妊娠结局风险增加,提醒应重视对于该部分人群采取密切监测等有效管理措施,以减少不良妊娠结局的发生。

It has been accepted that pregnant women should receive antihypertensive therapy when the blood pressure is≥160/110 mmHg(1 mmHg=0.133 kPa).However,a consensus is yet to be reached worldwide regarding whether lowering blood pressure is required for pregnant women with mild hypertension(blood pressure<160/110 mmHg).Diagnosis and treatment of hypertension and pre-eclampsia in pregnancy:a clinical practice guideline in China(2020)recommends that pregnant women whose blood pressure are≥140/90 mmHg should be treated with antihypertensive therapy.A recent study has shown that antihypertensive therapy for pregnant women with blood pressure over 140/90 mmHg could improve the pregnancy outcomes,providing further evidence for the recommendation in the 2020 guideline in China.Current studies have shown that the risk of adverse pregnancy outcomes increases in pregnant women with normal high blood pressure(130-139/80-89 mmHg),which indicates that effective management measures such as close monitoring should be conducted for this population,in order to reduce the adverse pregnancy outcomes.