How do I manage hypertension before, during and after pregnancy?

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Part of overall health is healthy living, including a good diet, good sleep patterns, well maintained weight, a healthy approach to stress and good management of blood pressure.

If you have difficult to control blood pressure, lifestyle changes alone may not be enough and medications become necessary.

We need to make sure that the medications are consistent with safety during pregnancy, which is why we always encourage medications to be arranged before pregnancy occurs.

Increased progesterone during pregnancy often causes your blood vessels to relax during the first and second trimesters. But it begins to rise from 24 weeks onward when you have an additional litre of blood pumping through your body. Which is why it’s so important to manage before becoming pregnant.

A commonly prescribed treatment is Labetalol. It is thought to be safe and does not cause excessive fatigue like some other medications can. Your doctor may begin your dose at 100 mg twice a day and increase, as needed, to 200 mg twice a day.

If Labetalol alone is not sufficient, your physician may add in Methyldopa, or long-acting formulations of Nifedipine, if the former two medications together are insufficient. It is also possible to add in Thiazide diuretics.

Though the evidence of Aspirin’s effectiveness for blood pressure is limited, there is no harm in taking ASA 81 mg daily.

Talk with your physician about your medication options. It may take a little time and adjusting your medication to find the right balance for you.

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