Chronic hypertension (CHTN) is a condition in which elevated blood pressure (BP) predates pregnancy or is first diagnosed in pregnancy before 20 weeks' gestation. It affects approximately 2% or more of pregnant patients, depending on diagnostic criteria, and is associated with increased short- and long-term adverse maternal and neonatal outcomes. The American College of Obstetricians and Gynecologists (ACOG) defines CHTN during pregnancy as elevated BPs greater than 140/90 mm Hg on atleast 2 occasions, 4 hours apart, and occurring before 20 weeks' gestation. However, oin the nonpregnant patient, the diagnosis of CHTN is now >=130/80 mm Hg on at least 2 occasions at least 4 hours apart, following recent changes to diagnosis guidelines in 2017 by the American College of Cardiology (ACC) and the American Heart Association (AHA). These changes in diagnostic criteria were a result of the increased long-term cardiovascular morbidity in individuals with BPs in the range of 130- to 139/80- to 89 mm Hg. Therefore, nonpregnant patients will be diagnosed with CHTN using lower BP thresholds than those used in pregnancy and will in turn increase the prevalence of pregnant patients with CHTN.
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