title: Hypertension in pregnancy: natural history and treatment options.
abstract: Hypertensive disorders of pregnancy affect approximately 5-10% of all maternities and are major contributors of maternal and neonatal morbidity and mortality worldwide. This group of disorders encompasses chronic hypertension, as well as conditions that arise de novo in pregnancy: gestational hypertension and pre-eclampsia. The latter group is thought to be part of the same continuum but with arbitrary division. Research into the aetiology of hypertension in pregnancy have largely been focused on pre-eclampsia, with a majority of studies exploring either pregnancy-associated factors such as placental-derived or immunologic responses to pregnancy tissue, or maternal constitutional factors such as cardiovascular health and endothelial dysfunction. The evidence base for the pathophysiology and progression of hypertensive disorders in pregnancy, particularly pre-eclampsia, is reviewed. Clinical algorithms and pharmacological agents for the management of hypertension in pregnancy are summarised, with a brief focus on post-partum considerations and long-term health implications. Novel therapeutic options for the management of pre-eclampsia are also explored.
authors.affiliation: Department of Surgery & Cancer, Faculty of Medicine, Imperial College London, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK, ffoo@imperial.ac.uk.
authors.forename: L
authors.initials: L
authors.lastname: Foo
authors.forename: J
authors.initials: J
authors.lastname: Tay
authors.forename: C C
authors.initials: CC
authors.lastname: Lees
authors.forename: C M
authors.initials: CM
authors.lastname: McEniery
authors.forename: I B
authors.initials: IB
authors.lastname: Wilkinson
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy*; D010920:Placenta; D011247:Pregnancy; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents
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