Pregnancy is a transformative and exciting time in a woman’s life, but it can also come with its share of challenges, especially if you have been diagnosed with a hypertensive disorder of pregnancy.
What does this mean?
Hypertension is the medical term used for high blood pressure. These two words are often used interchangeably, just as they will be in this post. Hypertension during pregnancy can increase the risk of complications such as preeclampsia, preterm birth, and low birth weight. Therefore, it is crucial to manage your blood pressure through lifestyle modifications, including dietary choices.
The majority of guidelines worldwide, define hypertension in pregnancy as a blood pressure of greater than 140/90mmHg. There are five main categories that are included as hypertensive disorders of pregnancy. Each of these five conditions have different definitions, which is important to understand (also associated with lots of big medical and science type words)!
1) Chronic hypertension (long term high blood pressure): is known as high blood pressure that occurs before pregnancy, or raised blood pressure before 20 weeks gestation.
2) Gestational hypertension: is a rise in blood pressure (without any other symptoms) during the second half of pregnancy.
3) Pre-eclampsia and or/eclampsia: is a multisystem disorder, that only occurs in pregnancy. This is characterised by raised blood pressure and high levels of protein in the urine. It often happens after 20 weeks gestation.
4) Eclampsia is the most serious of these, which refers to one or more convulsions/seizures as a result of pre-eclampsia.
5) pre-eclampsia with chronic hypertension: this means a person may have had high blood pressure previous to pregnancy, and then develops pre-eclampsia in pregnancy. Gestational diabetes is also another “sub category” condition that pops up as having a relationship to hypertension in pregnancy.
Hypertensive disorders of pregnancy are thought to affect 5-10% of pregnant women worldwide. Pre-eclampsia affects this same percentage of pregnant women in Australia, with 1-2% of these resulting in severe pre-eclampsia/eclampsia. Having a hypertensive disorder in pregnancy doesn’t just impact the pregnancy, but can result in long term health issues. Heart attack, ischaemic heart disease, stroke, and diabetes are 2-3 times more likely to occur in those who had hypertensive disorders in pregnancy. One of the most controllable risk factors is smoking status.
Some uncontrollable factors that can increase the risk of pre-eclampsia include:
- Previous history of pre-eclampsia
- Family history of pre-eclampsia
- Greater than 10 years between pregnancies
- Twin or triplet pregnancy
- Pre-existing medical conditions such as:
– Congenital heart defects
– Pre-existing diabetes
– Kidney disease
– Chronic high blood pressure
– Chronic autoimmune disease - Age ≥ 40 years
- Weight (BMI >35kg/m2)
- Maternal depression or anxiety
- Use of Assisted reproductive technology to fall pregnant
Despite the seriousness of hypertensive disorders in pregnancy, there is limited research and education resources available for women to make changes to reduce their risk of developing these. This calls for closer monitoring of women during pregnancy for improved long term health outcomes. Any type of high blood pressure in pregnancy requires special attention to ensure both the mother and baby’s health. The dietary patterns, or dietary intake of pregnant women can contribute to this risk. One essential aspect of managing a hypertensive disorder during pregnancy is proper nutrition.
Nutrition Tips for Hypertension in Pregnancy
Reduce your intake of salt
Reducing sodium (salt) intake is a key strategy for managing any type of hypertension. Try your best to avoid processed and fast foods. Some of the key sources of sodium in Australian foods are fast food, potato crisps, processed meat and meat products, including sausages, meat pies, sausage rolls and chicken nuggets, cheese and pizza. Other high sodium foods include a range of sauces, spreads and condiments. Instead, opt for fresh, whole foods prepared at home, and use herbs and spices to flavour your dishes.
Focus on fruits and vegetables
Fruits and vegetables are rich in essential nutrients, fibre, and importantly antioxidants. This can be helpful in regulating blood pressure. Antioxidants can protect cells from oxidative stress and inflammation, which are believed to contribute to pre-eclampsia. Aim to fill half your plate with colour! Always include leafy greens for their folate content, and 2 or more colours to add to the plate! This can go for your snacks too – choose some berries to add to your yoghurt or breakfast in the morning
Wholegrain carbohydrates are king
Wholegrains like brown rice, quinoa, wholemeal pasta, multigrain bread and oats are high in fibre and can help stabilize blood sugar levels. As they are higher in fibre, they keep you full for longer, and reduce cravings for some of the lower quality carbohydrates. If you can, try to purchase your bread from a bakery, or if you’re feeling creative, make it yourself! This way you can control how much sodium is added.
Have some fun with your proteins
Opt for lean sources of protein, such as skinless poultry, fish, lentils, chickpeas, beans, and tofu. These options are lower in saturated fat and can support your overall cardiovascular health, reducing risk of future cardiovascular disease. Omega 3 fatty acids play a key role in ensuring a healthy pregnancy. High intakes of EPA and DHA (the omega 3’s found in fish) are known to prevent preterm labour, lower the risk of pre-eclampsia and increase baby’s overall birthweight (in a positive way).
Be mindful of coffee and alcohol intake
Caffeine and alcohol can impact blood pressure. Alcohol should be cut out completely in pregnancy. Caffeine is okay in pregnancy, below 200mg (approximately 3-4 cups of black tea or 1-2 coffees a day). Pay attention to how your body responds when you do have caffeine and adjust your intake accordingly.
Sort out your supplements
Having a supplement or supplement plan that is tailored to you is just as important as an optimal diet in pregnancy. There are some nutrients that have good research behind them in reducing risk of pre-eclampsia (as well as Omega 3 fatty acids).
- Adequate intake of calcium can help regulate blood pressure and reduce the risk of hypertension, a common symptom of pre-eclampsia. Dairy products, leafy greens, almonds, chia seeds and fortified foods are good sources of calcium.
- Vitamin D plays a crucial role in immune function and may contribute to a healthier pregnancy. You can get vitamin D from sunlight exposure, fortified foods, and supplements.
- Magnesium helps maintain healthy blood pressure levels and muscle function. Nuts, seeds, whole grains, and green leafy vegetables are magnesium-rich foods.
- Potassium helps to regulate blood pressure and maintain fluid balance in the body. Bananas, sweet potatoes, and beans are rich in potassium.
Take control of your pregnancy and book in for a prenatal supplement consultation
Hydration
Proper hydration is crucial during pregnancy, but opt for water and herbal teas rather than sugary drinks. Adequate hydration can help maintain blood volume and circulation. Chronic dehydration also can be a cause of high blood pressure by making the body hold onto sodium. By having enough fluid in the day, the body is able to flush out any excess sodium and waste.
Gentle movement
Prioritise at least 30 minutes of safe physical activity on most days. Make sure you do check in with a women’s health physio, or your GP around what is safe for you in pregnancy.
Read more about exercise and nutrition in pregnancy
Check your blood pressure
Keep regular track of your blood pressure at home and report any significant changes or concerns to your healthcare provider. Work with your GP, obstetrician and Accredited Practising Dietitian to ensure the best outcomes for you and your baby
Maintaining a healthy diet is a vital component of managing hypertensive conditions during pregnancy. A well-balanced diet that includes these nutrients through both food and supplementation can be helpful in reducing the risk of pre-eclampsia or a hypertensive condition and support a healthy pregnancy.
Always remember to consult with your healthcare provider for personalized advice and monitoring throughout your pregnancy journey. You are doing a wonderful job in caring for yourself and your little one on the way!
