scholarly journals Identifying hypertension in pregnancy using electronic medical records: The importance of blood pressure values

2020 ◽  
Vol 19 ◽  
pp. 112-118 ◽  
Author(s):  
Lu Chen ◽  
Susan M Shortreed ◽  
Thomas Easterling ◽  
T Craig Cheetham ◽  
Kristi Reynolds ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Hypertension In Pregnancy ◽  
In Pregnancy

Hyponatremia associated with preeclampsia

2017 ◽  
Vol 45 (4) ◽  
Author(s):  
Armin S. Razavi ◽  
Stephen T. Chasen ◽  
Ritu Gyawali ◽  
Robin B. Kalish
Keyword(s):  
Older Women ◽  
Electronic Medical Records ◽  
Serum Sodium ◽  
Medical Records ◽  
Sodium Level ◽  
Descriptive Study ◽  
Clinical Factors ◽  
Factors Associated ◽  
Hypertension In Pregnancy ◽  
In Pregnancy

AbstractObjective:The objective of our study was to evaluate the prevalence and clinical factors associated with hyponatremia in patients with preeclampsia.Study design:This is a descriptive study of all patients who delivered at our institution from 2013 to 2014. Patients with preeclampsia were identified from electronic medical records. Preeclampsia with and without severe features was defined using the criteria outlined in the American Congress of Obstetricians and Gynecologists Hypertension in Pregnancy guidelines. As sodium levels have been shown to be approximately 5 mEq/L lower in pregnancy, hyponatremia was defined as a sodium level <130 mEq/L.Results:We identified 332 pregnancies complicated by preeclampsia, including 277 singletons and 55 twins. Hyponatremia was noted in 32 (9.7%) patients. Preeclampsia with severe features was present in the majority of patients with hyponatremia, and hyponatremia was more common in those with preeclampsia with severe features compared to those without (P<0.001). Hyponatremia also occurred more frequently in twins (P=0.001) and in older women (P=0.017). Only one patient without hyponatremia had an eclamptic seizure.Conclusion:Hyponatremia is not uncommon in preeclampsia, and is even more common in those with preeclampsia with severe features and twin gestations. As women with preeclampsia are at risk for hyponatremia, serum sodium should be monitored, especially in women with preeclampsia with severe features or twin gestations.

Hypertensive Disorders in Pregnancy

2017 ◽  
Author(s):  
Kavitha Vellanki ◽  
Susan Hou
Keyword(s):  
Blood Pressure ◽  
Organ Damage ◽  
The United States ◽  
Blood Pressure Target ◽  
Maternal Complications ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Few Data ◽  
In Pregnancy ◽  
New Onset

Hypertensive disorders are the second leading cause of maternal mortality in the United States. Hypertension in pregnancy is defined as blood pressure greater than or equal to 140 mm Hg systolic or greater than or equal to 90 mm Hg diastolic, measured on at least two separate occasions. Preeclampsia, as per the new guidelines, is characterized by the new onset of hypertension and either proteinuria or other end-organ dysfunction, more often after 20 weeks of gestation in a previously normotensive pregnant woman. New-onset proteinuria is not required for diagnosis of preeclampsia if there is evidence of other end-organ damage—a change from previous classifications. Although no screening test has yet proven accurate enough to predict preeclampsia, the use of a combination of the serologic factors seems promising. There are few data to support any specific blood pressure target in pregnancy. Although there is a general consensus on treating severe hypertension in pregnancy, there is a difference of opinion on treating mild to moderate hypertension in pregnancy. Avoiding uteroplacental ischemia and minimizing fetal exposure to adverse effects of medications are as important as avoiding maternal complications from high blood pressure during pregnancy. This review contains 2 figures, 4 tables, and 73 references.

The renin-aldosterone system in pre-eclampsia, essential and transient hypertension during pregnancy, and normotensive pregnant and non-pregnant control subjects

1982 ◽  
Vol 101 (2) ◽  
pp. 273-280 ◽  
Author(s):  
E. B. Pedersen ◽  
A. B. Rasmussen ◽  
P. Johannesen ◽  
H. J. Kornerup ◽  
S. Kristensen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Renin ◽  
Urinary Sodium Excretion ◽  
Third Trimester ◽  
Plasma Aldosterone Concentration ◽  
The Third ◽  
Control Subjects ◽  
Hypertension In Pregnancy ◽  
Normotensive Pregnancy ◽  
In Pregnancy

Abstract. Plasma renin concentration (PRC), plasma aldosterone concentration (PAC), and blood pressure were determined in the third trimester in pregnancy, 5 days and 6 months after delivery in pre-eclampsia, essential and transient hypertension in pregnancy and in normotensive pregnant and non-pregnant control subjects. PRC and PAC were elevated several fold above non-pregnant level in all groups during pregnancy. In pre-eclampsia PRC and PAC were 220 and 160%, respectively, above the levels 6 months after delivery, and thus lower than the corresponding values, 360 and 402%, in normotensive pregnancy. In essential and transient hypertension PRC and PAC increased to the same degree as during normotensive pregnancy. Urinary sodium excretion, serum sodium and creatinine clearance were reduced in pre-eclampsia, but not in essential and transient hypertension when compared to normotensive pregnant controls. All the parameters determined were the same as in non-pregnant controls 6 months after delivery in all groups. There were no correlations between blood pressure and PRC or PAC in any of the groups neither in pregnancy nor after delivery. It is concluded that the renin-aldosterone system is stimulated in lesser degree in pre-eclampsia than in both essential hypertension, transient hypertension and normotensive pregnancy, and there was no evidence for a causal relationship between the renin-aldosterone system and blood pressure neither in normotensive nor hypertensive pregnancy.

Abstract 372: Electronic Medical Records Can Identify Patients With Persistently Elevated Blood Pressure Without A Prior Diagnosis Of Hypertension.

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Olufunso W Odunukan ◽  
Ahmed S Rahman ◽  
Daniel Roellinger ◽  
Steven Cha ◽  
James M Naessens ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Elevated Blood Pressure ◽  
Electronic Records ◽  
Elevated Blood ◽  
Cross Sectional ◽  
Outpatient Visits ◽  
Cross Sectional Design ◽  
Diagnosis Of Hypertension

Background: The diagnosis of hypertension requires systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg on at least 2 different occasions. Therefore, there is the possibility of patients with elevated BP remaining undiagnosed if not seen by the same provider. Purpose: To utilize electronic medical records (EMR) to identify patients not previously diagnosed with hypertension that have elevated blood pressure meeting criteria for a diagnosis of hypertension using a threshold of SBP ≥ 140mmHg or DBP ≥ 90 mmHg (high BP) on 2 or more occasions. Methods: This was a cross sectional design utilizing retrospective multi-year billing and clinical data from a large multi-specialty center in the Midwest. Using electronic records of all outpatient visits in each year from 2009 - 2011, patients with at least 2 visits with SBP ≥ 140mmHg or DBP ≥ 90 mmHg (2HBP) in the measurement year were identified. These patients were compared with previously identified cohorts of known hypertension patients (Known HTN) compiled using the EMR problem list. A sensitivity analysis was done using patients with high BP at 2 consecutive visits (2CHBP) and also those with high BP at 3 consecutive visits (3CHBP). We compared proportions of patients with high BP without a prior diagnosis of hypertension (UDHTN). Results: The proportion of patients with SBP ≥ 140mmHg or DBP ≥ 90 mmHg without a prior diagnosis of hypertension (UDHTN) when compared to the cohort of known patients with a diagnosis of hypertension (Known HTN) was 25% in 2009, 26% in 2010, and 28% in 2011 in the 2CHBP cohort compared to 27% in 2009, 28% in 2010, and 30% in 2011 in the 2HBP cohort and 18% in 2009, 19% in 2010 and 23% in 2011 in the 3CHBP cohort. Conclusion: About a quarter of patients meeting current thresholds on multiple and consecutive visits did not have a known diagnosis of hypertension. The use of EMR can identify these patients for commencement of appropriate management. Table 1

Abstract 119: Using Blood Pressure Values from Electronic Medical Records to Identify Hypertension During Pregnancy

Hypertension ◽  
2018 ◽  
Vol 72 (Suppl_1) ◽  
Author(s):  
Lu Chen ◽  
Thomas Easterling ◽  
T. Craig Cheetham ◽  
Kristi Reynolds ◽  
Lyndsay Avalos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Electronic Medical Records ◽  
Medical Records

Hypertensive disorders

ESC CardioMed ◽  
2018 ◽  
pp. 2872-2874
Author(s):  
Renata Cifkova
Keyword(s):  
Blood Pressure ◽  
Laboratory Tests ◽  
Medical Complications ◽  
Pharmacological Management ◽  
Hypertension In Pregnancy ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Diagnosis Of Hypertension ◽  
In Pregnancy

Hypertensive disorders in pregnancy are the most common medical complications affecting 5–10% of pregnancies worldwide. This chapter discusses the following topics: diagnosis of hypertension, definition and classification of hypertension in pregnancy, additional laboratory tests, management of hypertension in pregnancy, pharmacological management of hypertension in pregnancy, delivery induction, blood pressure postpartum and lactation, and prognosis after pregnancy.

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