SECTION: Cardiology

Scheme Name: Hypertension in Pregnancy


Definition: DBP  ≥ 90 mmHg based on two measurements

Branch 1: Pre-existing Hypertension

Before pregnancy OR <20 weeks gestational age


  • Branch 1a: No proteinuria
    • Chronic Hypertension
      • Primary
      • Secondary
      • Branch 1b: Proteinuria (≥0.3g/24hr urine) OR one or more Adverse Conditions* (Side-note for tech team: adverse conditions presented in chart form below scheme)
        • Pre-existing hypertension with Pre-Eclampsia


Branch 2: Gestational Hypertension

Previously normotensive, >20 weeks gestational age


Adverse Conditions Chart:

To be created later

Hypertension Primary (Essential) (95%)Onset between age 20 and 50.Positive family history. No features of secondary hypertension. Secondary (5%)Onset age < 20 or > 50 years.No family history. Hypertensive urgency. Resistant hypertension.MislabelledRepeatedly normal blood pressure when taken at home, work or when using an ambulatory monitor. HYPERTENSION Definition of hypertension:Systolic BP >= 140mmHg or Diastolic BP >= 90mm Hg Isolated systolic hypertension in the elderly: >= 160mmHgDiabetes mellitus >=  130/80mmHgNote: In children, the definition of hypertension is different (either systolic or diastolic BP >95%ile), but the approach is the same. White-coat Hypertension Masked Hypertension Long-standing Uncontrolled Drug Withdrawal Exogenous Renal Mechanical Endocrine Corticosteroids Oral Contraceptive Pills Cocaine Black licorice Medications Renal parenchymal disease CKDAKIGlomerulonephritis Renovascular disease (unilateral and bilateral renal artery stenosis) Aortic coarctation Obstructive Sleep Apnea Glucocorticoid excess (Cushing syndrome or disease)Catecholamine excess (pheochromocytoma) Mineralocorticoid excess (primary aldosteronism) Hyperthyroidism (mainly systolic hypertension) Hypothyroidism (mainly diastolic hypertension)HyperparathyroidismPregnancy (Gestational hypertension)Hypertensive Urgency: BP usually >180/110mmHg or asymptomatic Diastolic BP >130mmHg with target organ damage usually present but not acutely changingHypertensive Emergency: BP usually >220/140mmHg with evolving target organ damage

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