Hypertension during pregnancy can be a problem for both baby and the mother. Thus it is of utmost importance that during pregnancy a good health should be maintained along with controlled blood pressure and cholesterol levels. With an increase in multiple births and women of older age the risk of hypertension during pregnancy has increased. But if proper care is taken it can be avoided.

Types of Pregnancy Hypertension:

There are three prominent forms of hypertension that can be seen during pregnancy. The pregnant ladies should be aware of the same. These are:

- Preeclampsia - This is the most common and serious hypertension during pregnancy. This hypertension can only be controlled by delivering the fetus which usually involves complications like death of the mother or child. This occurs 20 weeks after pregnancy.

- Gestational Hypertension - This form is only prevalent during pregnancy and is not a problem for the mother or baby after delivery. This usually occurs in the last leg of the pregnancy

- Chronic Hypertension - This form forms either prior to the pregnancy or before 20 weeks of the pregnancy.

Management of Pregnancy Hypertension:

Hypertension during pregnancy can be handled by the following:

- In case of severe hypertension, blood pressure medication should be continued during pregnancy

- If you are on ACE inhibitor-type medication, then the medication is changed to one that is even safe for the baby

- Your doctor might like to monitor you daily and can advise hospitalization for a few days

- If medication is missed, it might lead to uncontrolled life-threatening hypertension. Thus the medication should not be missed at any time

- In case of mild hypertension and absence of other diseases like diabetes and kidney disorders, the doctor might stop the medication or reduce the dose. Also, being off medicine does not cause any problem in mild hypertension.

- Irrespective of the hypertension being mild or severe, the prenatal appointments should not be missed, so that the doctor can monitor you and the baby. If any problems, like rise in blood pressure, poor fetal growth, and signs of preeclampsia can be spotted and steps can be taken for the same.

- In case there is some form of hypertension present the prenatal visits and lab tests will be more

- Apart from the usual second trimester ultrasound, there will be periodic ultrasounds in the third trimester to monitor the baby's growth and the amniotic fluid.

- Also regular fetal tests and Doppler ultrasounds will be done to track the baby's growth.

- Lifestyle changes should be made. Salt intake should be limited, fresh food instead of processed food should be consumed.

- If blood pressure is high then doctor might ask you to avoid exercise especially if you never did before pregnancy.

Sleep walking is a sleep related disorder that affects many individuals globally. It causes people to get up and start walking even when they are in a deep state of sleep. This condition happens when the patient is going through a state of deep sleep to light sleep, before actually awaking. In most cases, the patients are not aware of their actions and may find themselves in another room or part of the house when they wake up. While this condition usually happens for children between the ages of four to eight, it may even happen for certain adults. Here is everything you need to know about sleep walking from the reasons that cause it, to the ways in which it may be treated.

General causes of sleepwalking: Sleepwalking may be caused by sudden stress or a chaotic sleep pattern. In such cases, it may last only a few weeks and may even come with other symptoms like bedwetting. This is most commonly seen in children. It is also a genetically inherited disorder that can affect people whose parents or siblings have suffered from the same.

Also, if you have a sleep deprivation problem and experience trouble when it comes to falling asleep, then this condition may set in. Many people also walk in their sleep when they are drunk or are known to regularly get drunk. Excessive alcohol consumption may also lead to such sleep disorders. Also, if the patient is taking sedatives that are hypnotic in nature, then they may experience such symptoms as sleep walking.

Medical conditions: There are also a number of medical conditions that may cause this condition. To begin with, sleepwalking may arise as a symptom of heartburn and fever. Also, patients who are suffering from an irregular heartbeat or heart rhythm may end up walking in their sleep. Restless leg syndrome, obstructive sleep apnea, night time seizures and asthma may also cause this condition. Other psychiatric disorders like post-traumatic stress disorder, panic attacks and multiple personality disorder can also cause symptoms such as sleep walking.

Treatment: The method of treatment is usually based on the genetic, environmental or physiological reasons that are behind the actual disorder. While changing the medicines and treating the actual ailment that causes sleep walking as a symptom may be recommended by most doctors, one may also have to undergo therapy. This therapy will help in reaching the root cause of the sleepwalking disorder in case it is a chronic problem that has nothing to do with any other ailment or disease. The doctor may also look for signs of nocturnal seizures and confusion arousal in order to treat the same with proper therapy and medication.

High blood pressure – or hypertension – is common in both men and women, especially as we age. However, it tends to follow different patterns over the course of men’s and women’s lifetimes.

“In general, blood pressure in children and adolescents is equivalent between males and females,” says cardiologist Dr. Paula Harvey, director of the cardiovascular research program at Women’s College Hospital.

That pattern changes after puberty and through the teenage years. Through their reproductive years, women tend to have lower blood pressure than men the same age, and lower rates of hypertension.

“When women transition through menopause things start to change,” Dr. Harvey says. “Blood pressure in women starts to increase with age at a faster rate than it does with men, so you get a steepening of that age-related increase in blood pressure. By age 75 or 80, there are more women with high blood pressure than men.”

Age-related patterns

With age, specific types of high blood pressure become more prevalent in women compared to men. Around menopause and after, women experience a disproportionate increase in systolic blood pressure (the top number in a blood pressure reading) versus diastolic pressure (the lower number). This pattern of a high systolic reading and a normal diastolic is called isolated systolic hypertension (ISH). It is associated with a stiffening of the blood vessels that women experience after menopause.

“Before menopause, we have very pliant, stretchy blood vessels,” Dr. Harvey says. “In that second half of life they start to get very stiff, and that’s reflected in this change in pattern.”

Despite the low diastolic reading, ISH is still a health concern.

“You can’t be complacent because your diastolic reading is in the normal range,” Dr. Harvey cautions. “When it’s coupled with that high systolic reading, that’s actually reflecting stiff blood vessels, and we know that is associated with increased adverse outcomes from the hypertension.”

Older women with ISH may also experience variations in their blood pressure. It may rise if they are under stress or doing certain activities, then drop down again, then increase again.

“That isolated systolic hypertension pattern is more difficult to control, and is associated with all the risks that high blood pressure is associated with,” Dr. Harvey says. “We treat high blood pressure because it leads to increased risk of cardiovascular disease such as heart attacks and strokes, heart failure, heart rhythm disturbances, kidney failure and possibly dementia.”

Reproductive factors

Superimposed on those lifetime patterns of blood pressure are factors related to reproductive changes.

“Pregnancy can be associated in some women with pregnancy-induced hypertension,” Dr. Harvey says. “The contraceptive pill, which is used by very large numbers of women, can cause increased blood pressure in a small number of individuals.”

That increase in blood pressure can happen at any time a woman is taking birth control pills. That’s why Dr. Harvey recommends that all women taking the pill have their blood pressure checked annually.

Hormone replacement therapy used by perimenopausal and menopausal women does not appear to have the same effects on blood pressure as the contraceptive pill.

Sex and gender must also be taken into account when prescribing medication for hypertension.

“Because we are treating women at different stages in their lifespan we have to be very aware of the best treatments for them,” Dr. Harvey says. For example, great care must be taken when choosing medications for women of reproductive age who are likely to become pregnant, or women who are breastfeeding. After menopause, the ISH pattern of hypertension that is common in women responds better to certain classes of medication than others.

Lifestyle

Dr. Harvey stresses that some of the most effective interventions for hypertension at any age are not pharmaceutical.

“I’m very invested in lifestyle interventions,” she says. “I spend a lot of time talking to my patients about what they can do for themselves before we even start thinking about medication. Top of the list is exercise.”

Exercise can be as effective as drug therapy. For example, the ISH pattern of high blood pressure so often seen in postmenopausal women can be reduced with exercise.

“Exercise helps keep the blood vessels stretchy and pliant, so you don’t have that progression to very stiff blood vessels associated with ISH,” Dr. Harvey explains.

What you put in your body matters, too. The DASH (Dietary Approach to Stop Hypertension) diet – which stresses fresh fruit and vegetables, whole grains, fish, low fat intake and low salt – is recommended for people with hypertension. Alcohol recommendations follow the Canadian guidelines for low-risk drinking: no more than two drinks per day for women, and no more than 10 drinks per week in total.

The risks of smoking – including premature cardiovascular disease and death – cannot be overstated.

Other lifestyle factors associated with hypertension include obesity, life stress, and poor quality sleep. Addressing all of these factors can have a powerful effect on blood pressure, and on overall heart health.

Pregnant women who experience certain breathing problems during sleep may be more likely to develop complications like high blood pressure and diabetes, recent U.S. research suggests.

In the study of more than 3,000 women, researchers did home-based sleep studies twice during pregnancy to check for what's known as apnea, a potentially serious sleep disorder that involves repeated stops and starts in breathing. Risk factors for sleep apnea include older age and obesity.

Women who had sleep apnea were almost twice as likely to develop what's known as preeclampsia, a type of pregnancy-related high blood pressure, and up to 3.5 times more likely to develop pregnancy-related diabetes, the study found.

"Although we found an association with sleep disordered breathing preceding the development of both pregnancy-related hypertensive disorders and gestational diabetes, we cannot conclude that universal screening for, and treatment of sleep disordered breathing in pregnancy would reduce the risks of these adverse outcomes," said lead study author Dr. Francesca Facco of the University of Pittsburgh's Magee-Women's Hospital.
That's because even among people who are not pregnant, there isn't conclusive evidence that the most common treatment for apnea can reduce the risk of developing hypertension or diabetes, Facco said by email.

For the most common apnea treatment, patients wear breathing masks at night. The masks are connected to a machine that provides continuous positive airway pressure (CPAP), which splints the airway open with an airstream so the upper airway can't collapse during sleep.

Some patients can't tolerate sleeping with CPAP machines. This intervention may not make sense for pregnant women, particularly if they have only mild apnea, Facco said.

"We do not know if treating sleep-disordered breathing in pregnancy will improve clinical outcomes in pregnancy, and our study cannot answer that question," Facco added.

Sleep tests done for the study found that early in pregnancy, between six and 15 weeks gestation, 3.6 percent of the women had apnea. Later in pregnancy when they had gained more weight, between 22 and 31 weeks gestation, 8.3 percent of the women had apnea.

Overall, 6 percent of the women had preeclampsia, 13 percent had pregnancy-related hypertensive disorders and 4 percent developed gestational diabetes, researchers report in the journal Obstetrics and Gynecology.

Early in pregnancy, women with apnea were 94 percent more likely to develop preeclampsia, 46 percent more likely to have hypertensive disorders and 3.5 times more likely to develop diabetes than women without sleep disordered breathing.

Women who had apnea later in pregnancy were 95 percent more likely to develop preeclampsia, 73 percent more likely to develop hypertensive disorders, and 2.8 times more likely to have diabetes than women without sleep disordered breathing.

The study is observational and doesn't prove apnea causes these pregnancy complications.
One limitation of the study is the potential for home-based sleep tests to leave some cases of apnea undetected, potentially underestimating the prevalence of sleep-disordered breathing.

"Currently, we still need more data on whether improving or treating sleep-disordered breathing will lessen the risk of high blood pressure or diabetes during pregnancy," said Dr. Sirimon Reutrakul, a researcher at Mahidol University in Bangkok who wasn't involved in the study.

"However, overweight or obesity is a risk factor for high blood pressure and diabetes during pregnancy, as well as sleep-disordered breathing," Reutrakul added by email. "Therefore, keeping healthy body weight through diet and exercise should lessen the risk for these problems."

Women have many health reasons to start pregnancy at a healthy weight and a younger age, two things that may also lower the odds for apnea, said Dr. Marie-Pierre St-Onge, a researcher at Columbia University Medical Center in New York who wasn't involved in the study.

"Obstructive sleep apnea is associated with obesity," St-Onge said by email.

"Although this study did not find an interaction between weight status and OSA on hypertension and diabetes, I would suggest that women enter pregnancy at a normal weight and gain weight appropriate for their weight status," she said.

"Whenever possible, avoiding delaying pregnancy to a more advanced age would be advisable," St-Onge added.

High blood pressure can develop over many years and affects everyone at some point in life but if not treated for a very long time, it can escalate the risks of a number of cardiovascular problems and chronic kidney disorders.

High blood pressure or hypertension is a condition where the long term force induced by blood on the artery walls may lead to health complications.

Different types of hypertension:

Primary Hypertension: High blood pressure caused by genetic, prenatal or other natural causes like aging (people over 60 develop HBP) is known as primary hypertension.

Secondary Hypertension: Secondary hypertension is that which is caused due to specific conditions, like kidney disorders, lung disorders etc.

Symptoms Of Hypertension:

It may not show any warning symptoms for several years while it continues to develop. A few tell-tale signs are frequent throbbing headaches, shortness of breath, nosebleeds, excessive sweating but these only occur when there is an extremely serious medical complication.


Complications of hypertension:

Hypertension can also result in a disorder called aneurysm in which the blood vessels tend to swell and weaken. Rupture of an aneurysm can be fatal.
Heart failure is one of the most serious complications associated with hypertension. It becomes increasingly difficult for the heart to pump blood along with the high pressure. Consequently the heart muscle thickens and leads to cardiac arrest.

Uncontrolled high blood pressure and interference with your ability to remember and think. It can trigger memory loss and affect your understanding and deriving skills.

Persistent high blood pressure can result in atherosclerosis - hardening of the arteries. This can severely wreck cardiovascular health and cause stroke, heart attack or other complications.