Pregnant women with high blood pressure may have to worry about preeclampsia or eclampsia. Preeclampsia, also known as toxicemia of pregnancy, is indicated by high blood pressure, fluid retention, and protein in the urine. If left untreated, the condition may lead to eclampsia, a life-threatening condition. Reporting in Obstetrics and Gynecology (February 2005), the researchers said very high systolic pressure is a better warning sign of stroke in women with either condition, compared with diastolic pressure. The researchers stressed, however, physicians need to pay attention to both numbers.

For the study, the researchers examined case histories of 28 women who had a stroke connected with severe preeclampsia or eclampsia. Although only 3 of the patients had a diastolic pressure of 110 mm Hg or higher just before a stroke, the data showed that 23 of the patients had systolic blood pressures of 160 mm Hg or higher. All of the participants had systolic pressures >155 mm Hg. The case histories also showed that only 3 of the patients received treatment for their high blood pressure just prior to a stroke.

Moving forward, the researchers said they will have to determine how effective existing drugs will be in keeping systolic pressure below 160 mm Hg, and whether controlling systolic pressure will prevent stroke. In the meantime, the researchers recommend that women with severe preeclampsia and eclampsia and high systolic blood pressure receive immediate and special attention, intensive care, and blood pressure treatment to prevent stroke.