The Main Nutrients to Control in Hypertension in Pregnant Women
Arterial hypertension is a health problem with a great impact on the population. In 5% of pregnant women, it can appear before or during pregnancy. One of the main factors to take care of is the diet, so knowing the main nutrients to control hypertension in pregnant women can help to have a healthier pregnancy. We’ll tell you more below.
Hypertension during pregnancy
The WHO refers that arterial hypertension is a disorder where the blood vessels have persistently elevated pressure. Blood pressure is produced by the force of the blood pushing against the walls of the arteries every time the heart pumps. Therefore, the higher the blood pressure, the more difficult it is for the heart to pump blood.
When hypertension doesn’t manifest symptoms or isn’t treated, it can increase cardiovascular, brain, and kidney diseases, among others.
Arterial hypertension in pregnant women is classified into 4 types:
- Chronic hypertension: When blood pressure is high since before pregnancy.
- Gestational hypertension: When blood pressure rises for the first time after the 20th week of pregnancy. There are no signs of organ damage.
- Pregnancy-induced hypertension: Also known as preeclampsia, it occurs after 20 weeks of gestation. It complicates 3 to 5% of pregnancies and causes damage to other organs, such as the kidney, liver, blood or brain.
- Chronic hypertension with preeclampsia: In this case, chronic hypertension causes blood pressure to worsen during pregnancy.
Risks of hypertension in pregnancy
High blood pressure during pregnancy can present different risks. For example, less blood flow may reach the placenta and affect the supply of oxygen and nutrients to the fetus. In other cases, placental abruption occurs with intense bleeding and, in more extreme cases, premature delivery.
Among the dietary factors that most affect hypertension, deficiency or excess in certain nutrients and a high consumption of salt and visible fat, as well as obesity, are among the most studied.
Nutrients to control hypertension in pregnant women
According to the WHO, a healthy and balanced diet should help reduce the risk of preeclampsia. However, there are some key nutrients, in addition to sodium and potassium, that help prevent hypertension in pregnant women.
The journal Nutrients reveals that low calcium intake can lead to high blood pressure by stimulating the release of certain hormones. These cause constriction and increased resistance of blood vessels and increase blood pressure.
Supplementation of 1 gram of calcium per day is recommended from 20 weeks until delivery. Those at higher risk should ingest between 1 to 2 grams daily. The main food sources of calcium are fresh cheeses such as cottage cheese, yogurt, cottage cheese, and skim milk, among others.
Vitamin D may be protective against hypertension because of its ability to regulate proinflammatory responses, promote blood vessel formation, and lower blood pressure. In addition, supplementation results in decreased oxidative stress.
In pregnant women, supplementation of 10 to 25 micrograms per day is recommended to reduce the risk of preeclampsia. A review published in the Journal of Clinical Endocrinology and Metabolism has shown that vitamin D deficiency in the blood, between 50 and 75 nanomoles per liter, is a risk for developing preeclampsia. However, other researchers believe that more clinical trials should be designed in this regard.
A review reported in the Journal of Reproductive Immunology explains that selenium is part of proteins called selenoproteins. These reduce the oxidative stress and inflammation characteristic of preeclampsia.
A review carried out in 2020 shows that a low level of selenium may be a risk for preeclampsia. For this reason, it’s best to increase the consumption of its dietary sources, such as fish and seafood. This should include more than 2 servings per week. In addition, a pregnancy supplement containing 50 to 100 micrograms of selenium per day should be taken. Finally, the consumption of eggs, grains, chicken, and liver, among others, is recommended.
85% of the studies indicate that pregnant women with preeclampsia have a higher concentration of the amino acid homocysteine. Therefore, when folate is low, the concentration of homocysteine increases. In turn, folate reduces blood pressure and oxidative stress and restores blood flow through changes in blood vessel tone and diameter.
A daily intake of 400 micrograms of folic acid per day during the first trimester is recommended as a protective measure. The main sources of folic acid are dark green vegetables such as kale, spinach, Swiss chard, arugula, broccoli, Brussels sprouts, and others.
Omega-3 fatty acids
Some research has found that pregnant women who consumed 100 milligrams of the omega-3s, DHA, and EPA, decreased their risk of preeclampsia. The same occurred when they ingested one serving of fish per day. However, fish, in addition to omega-3s, also contains bioactive peptides with antihypertensive, antioxidant, and anti-inflammatory activities.
It should be noted that the fish and seafood that contain the most are salmon, mackerel, sardines, anchovies, herring, tuna, anchovies, and oysters, among others.
Pregnant women with preeclampsia have increased triglycerides and bad LDL cholesterol. Dietary fiber is capable of reducing them, as several studies have shown. At the same time, fiber helps reduce blood pressure and inflammation.
Experts suggest increasing fiber intake by 27 to 30 grams per day during pregnancy. However, it’s emphasized that, above this value, the risk may increase. Cereals and whole grains, legumes, whole fruits, vegetables, and other greens are good sources of fiber.
Sodium and potassium
Too much sodium and too little potassium have a direct effect on increasing blood pressure. Therefore, salt should be lowered or eliminated, as well as all those processed foods that contain it. At the same time, in case of deficiency, the consumption of fruits and vegetables containing potassium should be increased.
Obstetricians and nutritionists are in charge of controlling hypertension in pregnant women. The established dietary recommendations for vitamin D, calcium, selenium, sodium, potassium, omega-3s, fiber, and folic acid should be combined with other preventive strategies. For example, establishing screening policies and the indication of pharmacological agents by the treating physician.
As sodium is a mineral of concern in hypertension, it’s important to exclude foods that contain excess amounts of this mineral. For example, processed foods, canned foods, matured cheeses, bakery products, meat products, and any other food determined by the health professional.
One way to have a healthy pregnancy is to include a varied and balanced diet from the beginning. Lean proteins, whole grains, legumes, omega-3 fats, fruits and minimally processed fresh vegetables should predominate.It might interest you...
All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.
- Arvizu, M., Afeiche, M. C., Hansen, S., Halldorsson, T. F., Olsen, S. F., & Chavarro, J. E. (2019). Fat intake during pregnancy and risk of preeclampsia: a prospective cohort study in Denmark. European journal of clinical nutrition, 73(7), 1040–1048. https://doi.org/10.1038/s41430-018-0290-z
- Cheteu Wabo, T. M., Wu, X., Sun, C., Boah, M., Ngo Nkondjock, V. R., Kosgey Cheruiyot, J., Amporfro Adjei, D., & Shah, I. (2022). Association of dietary calcium, magnesium, sodium, and potassium intake and hypertension: a study on an 8-year dietary intake data from the National Health and Nutrition Examination Survey. Nutrition research and practice, 16(1), 74–93. https://doi.org/10.4162/nrp.2022.16.1.74
- Kinshella, M.-L., Omar, S., Scherbinsky, K., Vidler, M., Magee, L., von Dadelszen, P., Moore, S., et al. (2021). Effects of Maternal Nutritional Supplements and Dietary Interventions on Placental Complications: An Umbrella Review, Meta-Analysis and Evidence Map. Nutrients, 13(2), 472. MDPI AG. Retrieved from http://dx.doi.org/10.3390/nu13020472
- Mardali, F., Fatahi, S., Alinaghizadeh, M., Kord Varkaneh, H., Sohouli, M. H., Shidfar, F., & Găman, M. A. (2021). Association between abnormal maternal serum levels of vitamin B12 and preeclampsia: a systematic review and meta-analysis. Nutrition reviews, 79(5), 518–528. https://doi.org/10.1093/nutrit/nuaa096
- Organización Mundial de la Salud. OMS. Hipertensión. Disponible en: https://www.who.int/es/health-topics/hypertension#tab=tab_1
- Qiu, C., Coughlin, K. B., Frederick, I. O., Sorensen, T. K., & Williams, M. A. (2008). Dietary fiber intake in early pregnancy and risk of subsequent preeclampsia. American journal of hypertension, 21(8), 903–909. https://doi.org/10.1038/ajh.2008.209
- Roberts, J. M., & Bell, M. J. (2013). If we know so much about preeclampsia, why haven’t we cured the disease?. Journal of reproductive immunology, 99(1-2), 1–9. https://doi.org/10.1016/j.jri.2013.05.003
- Senevirathne, M., & Kim, S. K. (2012). Development of bioactive peptides from fish proteins and their health promoting ability. Advances in food and nutrition research, 65, 235–248. https://doi.org/10.1016/B978-0-12-416003-3.00015-9
- Singh, D. K., Sinha, N., Bera, O. P., Saleem, S. M., Tripathi, S., Shikha, D., Goyal, M., & Bhattacharya, S. (2021). Effects of diet on hypertensive disorders during pregnancy: A cross-sectional study from a teaching hospital. Journal of family medicine and primary care, 10(9), 3268–3272. https://doi.org/10.4103/jfmpc.jfmpc_96_21.
- Tabesh, M., Salehi-Abargouei, A., Tabesh, M., & Esmaillzadeh, A. (2013). Maternal vitamin D status and risk of pre-eclampsia: a systematic review and meta-analysis. The Journal of clinical endocrinology and metabolism, 98(8), 3165–3173. https://doi.org/10.1210/jc.2013-1257
- Villa-Etchegoyen, C., Lombarte, M., Matamoros, N., Belizán, J. M., & Cormick, G. (2019). Mechanisms involved in the relationship between low calcium intake and high blood pressure. Nutrients, 11(5), 1112.
- Winther, K. H., Rayman, M. P., Bonnema, S. J., & Hegedüs, L. (2020). Selenium in thyroid disorders – essential knowledge for clinicians. Nature reviews. Endocrinology, 16(3), 165–176. https://doi.org/10.1038/s41574-019-0311-6