Hypertension is among the most common conditions that affect women of reproductive age. It is also a common complication of pregnancy, and should be treated in pregnant women with blood pressures =160/110. For blood pressures 140-159/90-109, no clear data exist to demonstrate benefits of treatment. When treatment is indicated, labetalol and methyldopa are first-line agents. Most women, with or without hypertension, will not have an adverse effect on blood pressure from any form of contraception. Progestin-only methods, including the pill, injection, subdermal implant, and intrauterine device, are safe in women with hypertension, even if blood pressure is poorly controlled. Estrogen-containing methods, including the pill, patch, and ring, have all been shown to increase blood pressure, although the degree of increase has not been well established in the literature. In women with hypertension using these methods, data show an increased risk of both stroke and myocardial infarction, compared to women without hypertension. For these reasons, all women should have their blood pressure measured prior to initiation of estrogen-containing contraceptives. These methods are graded as category 4 (method poses an unacceptable health risk) in women with blood pressures ≥160/100. Because of data demonstrating a dose-dependent risk of cardiovascular events in women using contraceptives containing estrogen, when these methods are selected, doses ≤35 μg are universally preferred.
|Original language||English (US)|
|Title of host publication||Contraception for the Medically Challenging Patient|
|Publisher||Springer New York|
|Number of pages||13|
|State||Published - Jan 1 2014|
ASJC Scopus subject areas
- Health Professions(all)