Frequency and Pattern of Hypertension in Pregnancy in a Tertiary Care Hospital
Article Sidebar
Main Article Content
Abstract
Background: Hypertensive disorders of pregnancy are major contributors to maternal and perinatal morbidity and mortality, particularly in tertiary care settings where women often present with more advanced or complicated disease. Understanding the relative frequency of different hypertension subtypes during pregnancy may support earlier recognition and improved clinical management. Objective: To determine the frequency and pattern of hypertension in pregnancy among women presenting to a tertiary care hospital in Quetta. Methods: This cross-sectional observational study was conducted in the Department of Cardiology, Bolan Medical College/Hospital, Quetta, from 12 July 2025 to 31 December 2025. A total of 81 pregnant women aged 20 to 40 years with hypertension during pregnancy were included. Clinical and demographic variables were recorded, and hypertensive disorders were classified as gestational hypertension, chronic hypertension, pre-eclampsia, or eclampsia. Data were analyzed using IBM SPSS version 23, with frequencies, percentages, means, standard deviations, and chi-square testing used where appropriate. Results: The mean age of the participants was 29.68 ± 10.24 years. Pre-eclampsia was the most frequent hypertensive disorder, affecting 30 women (37.0%), followed by chronic hypertension in 25 (30.9%), eclampsia in 19 (23.5%), and gestational hypertension in 7 (8.6%). Most women had parity of 2 or less (77.8%) and gestational age greater than 28 weeks (70.4%). Stratified analysis showed no statistically significant association between hypertension subtype and age (p=0.842), gestational age (p=0.219), parity (p=0.753), or body mass index category (p=0.935). Conclusion: Pre-eclampsia was the predominant hypertensive disorder in this tertiary care population. Routine antenatal blood pressure surveillance and timely referral remain essential to reduce severe maternal complications.
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Trappe HJ. Tachyarrhythmias, bradyarrhythmias and acute coronary syndromes. J Emerg Trauma Shock. 2010;3(2):137-42.
2. Kashou AH, Braiteh N, Kashou HE. Reversible atrioventricular block and the importance of close follow-up: two cases of Lyme carditis. J Cardiol Cases. 2018;17(5):171-4.
3. Halbfass P, Sonne K, Nentwich K, Ene E, Deneke T. Current developments in cardiac rhythm management devices. Clin Res Cardiol. 2018;107(2):100-4.
4. Pokorney SD, Radder C, Schulte PJ, Al-Khatib SM, Tricocci P, Van de Werf F, et al. High-degree atrioventricular block, asystole, and electromechanical dissociation complicating non-ST-segment elevation myocardial infarction. Am Heart J. 2016;171(1):25-32.
5. Bhar-Amato J, Davies W, Agarwal S. Ventricular arrhythmia after acute myocardial infarction: “the perfect storm”. Arrhythm Electrophysiol Rev. 2017;6(3):134-9.
6. Javaid A, Rizvi FH, Ahmad I. In-hospital outcome of patients with acute ST-elevation myocardial infarction requiring temporary transvenous pacing. JSZMC. 2011;2(4):217-23.
7. Bhalli MA, Khan MQ, Samore NA, Mehreen S. Frequency and clinical outcome in conduction defects in acute myocardial infarction. J Ayub Med Coll Abbottabad. 2009;21(3):32-7.
8. Alam M, Mahmood M, Adhikary D, Khaled M, Chowdhury MSI, Hasan A, et al. The pattern of cardiac arrhythmias in acute ST elevated myocardial infarction and their in-hospital outcome. Univ Heart J. 2020;16:16-21.
9. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al. Third universal definition of myocardial infarction. J Am Coll Cardiol. 2012;60(16):1581-98.
10. Jennings RB, Ganote CE. Structural changes in myocardium during acute ischemia. Circ Res. 1974;35 Suppl 3:156-72.
11. Jaffe AS, Babuin L, Apple FS. Biomarkers in acute cardiac disease: the present and the future. J Am Coll Cardiol. 2006;48(1):1-11.
12. Roe MT, Harrington RA, Prosper DM, Pieper KS, Bhatt DL, Lincoff AM, et al. Clinical and therapeutic profile of patients presenting with acute coronary syndromes who do not have significant coronary artery disease. Circulation. 2000;102(10):1101-6.
13. Reynolds HR, Srichai MB, Iqbal SN, Slater JN, Mancini GB, Feit F, et al. Mechanisms of myocardial infarction in women without angiographically obstructive coronary artery disease. Circulation. 2011;124(13):1414-25.
14. Bertrand ME, LaBlanche JM, Tilmant PY, Thieuleux FA, Delforge M, Carre AG, et al. Frequency of provoked coronary arterial spasm in 1089 consecutive patients undergoing coronary arteriography. Circulation. 1982;65(7):1299-306.
15. Bugiardini R, Manfrini O, Pizzi C, Fontana F, Morgagni G. Endothelial function predicts future development of coronary artery disease: a study of women with chest pain and normal coronary angiograms. Circulation. 2004;109(21):2518-23.
16. Holmvang L, Jurlander B, Rasmussen C, Thiis JJ, Grande P, Clemmensen P. Use of biochemical markers of infarction for diagnosing perioperative myocardial infarction and early graft occlusion after coronary artery bypass surgery. Chest. 2002;121(1):103-11.
17. Zimetbaum PJ, Josephson ME. Use of the electrocardiogram in acute myocardial infarction. N Engl J Med. 2003;348(10):933-40.
18. Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2016;37(3):267-315.
19. D’Avanzo B, Santoro L, La Vecchia C, Maggioni A, Nobili A, Iacuitti G, et al. Physical activity and the risk of acute myocardial infarction. Ann Epidemiol. 1993;3(6):645-51.
20. Gong J, Campos H, Fiecas JM, McGarvey ST, Goldberg R, Richardson C, et al. A case-control study of physical activity patterns and risk of non-fatal myocardial infarction. BMC Public Health. 2013;13:122.
21. Zhang H, Sun S, Tong L, Li R, Cao XH, Zhang BH, et al. Effect of cigarette smoking on clinical outcomes of hospitalized Chinese male smokers with acute myocardial infarction. Chin Med J (Engl). 2010;123(20):2807-11.
22. Alemu R, Fuller EE, Harper JF, Feldman M. Influence of smoking on the location of acute myocardial infarctions. ISRN Cardiol. 2011;2011:174358.
23. Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ. 2011;342:d671.
24. Stampfer MJ, Krauss RM, Ma J, Blanche PJ, Holl LG, Sacks FM, et al. A prospective study of triglyceride level, low-density lipoprotein particle diameter, and risk of myocardial infarction. JAMA. 1996;276(11):882-8.
25. Gu K, Cowie CC, Harris MI. Mortality in adults with and without diabetes in a national cohort of the US population, 1971-1993. Diabetes Care. 1998;21(7):1138-45.
26. Kannel WB, Gordon T, Schwartz MJ. Systolic versus diastolic blood pressure and risk of coronary heart disease: the Framingham Study. Am J Cardiol. 1971;27(4):335-46.
27. Zhu J, Su X, Li G, Chen J, Tang B, Yang Y. The incidence of acute myocardial infarction in relation to overweight and obesity: a meta-analysis. Arch Med Sci. 2014;10(5):855-62.
28. Mostofsky E, Maclure M, Sherwood JB, Tofler GH, Muller JE, Mittleman MA. Risk of acute myocardial infarction after the death of a significant person in one’s life: the Determinants of Myocardial Infarction Onset Study. Circulation. 2012;125(3):491-6.
29. Guo F, Wang X, Li G, Chen X, Jin Y. Risk factors of acute myocardial infarction following primary percutaneous coronary intervention among elderly patients. J Geriatr Cardiol. 2009;6:67-70.
30. Huma S, Tariq R, Amin DF, Mahmood DKT. Modifiable and non-modifiable predisposing risk factors of myocardial infarction: a review. J Pharm Sci Res. 2012;4:1649-53.
31. Prabhakaran D, Jeemon P. Should your family history of coronary heart disease scare you? Mt Sinai J Med. 2012;79(6):721-32.
32. Arbab-Zadeh A, Fuster V. The myth of the “vulnerable plaque”: transitioning from a focus on individual lesions to atherosclerotic disease burden for coronary artery disease risk assessment. J Am Coll Cardiol. 2015;65(8):846-55.
33. Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E, Mintz GS, et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011;364(3):226-35.
34. Kubo T, Maehara A, Mintz GS, Doi H, Tsujita K, Choi SY, et al. The dynamic nature of coronary artery lesion morphology assessed by serial virtual histology intravascular ultrasound tissue characterization. J Am Coll Cardiol. 2010;55(15):1590-7.
35. Ahmadi A, Leipsic J, Blankstein R, Taylor C, Hecht H, Stone GW, et al. Do plaques rapidly progress prior to myocardial infarction? The interplay between plaque vulnerability and progression. Circ Res. 2015;117(1):99-104.