The Open Nursing Journal

ISSN: 1874-4346 ― Volume 14, 2020

Management of Chronic and Gestational Hypertension of Pregnancy: A Guide for Primary Care Nurse Practitioners

Leah Spiro*, Donna Scemons
California State University, Los Angeles, USA



The aim of this discussion paper is to outline the guidelines, according to the American Congress of Obstetricians and Gynecologists, about how to manage hypertension before and during pregnancy. Primary providers lack the knowledge to initiate treatment and manage hypertension in patients who are family planning or in the early stages of pregnancy before transferring care to an obstetrician, or perhaps patients who never do transfer care for lack of accessibility or funding. This paper aims to discuss how the Family Nurse Practitioner, or other primary care providers, may safely and efficiently maintain stable blood pressures in patients with hypertension before, during, and after pregnancy.

Background and Implications for Nursing:

Clinicians often defer gestational complications to obstetricians, however, it is crucial that there is a basic understanding of how to manage such issues. Primary practitioners do care for these patients during pre-gestation or fertility planning and oftentimes even during pregnancy in underserved communities with little access to obstetrical / prenatal care.


Discussion paper of ACOG guidelines and recommendations regarding safe management of hypertension before, during and after pregnancy.

Data Sources:

Inclusion criteria utilized most current research within the past 5 years, barring one source from the American Heart Association (no more current data) from 2011. This included an examination of current standards of care regarding hypertension during and before pregnancy according to the ACOG. Utilizing keywords such as hypertension, gestational hypertension, pregnancy, pharmacological management of hypertension, ACOG guidelines, treatment of hypertension in pregnancy. The decision to utilize guidelines set forth primarily by ACOG stems from ACOG being the governing body for Obstetricians / Gynecologists. Additionally, “standardization of care improves patient outcomes, which also should translate into a reduction in medical-legal exposure” [2]. As “such guidelines have been developed by specialty organizations such as the American College of Obstetricians and Gynecologists (the college),” ACOG guidelines are nationally utilized in the care of OB/GYN patients.


It is essential for primary care clinicians to employ current research regarding hypertension surrounding pregnancy and encourage patients who are family planning to utilize all such data in order to have a healthy and successful pregnancy. In order to do so, thorough practitioners are required to care for patients throughout the spectrum of all health and wellness related situations.

Keywords: Obstetics, Gastational hypertension, Pregestational hypertension, ACOG, Hypertension, Women.

Article Information

Identifiers and Pagination:

Year: 2018
Volume: 12
First Page: 180
Last Page: 183
Publisher Id: TONURSJ-12-180
DOI: 10.2174/1874434601812010180

Article History:

Received Date: 7/12/2017
Revision Received Date: 17/03/2018
Acceptance Date: 22/07/2018
Electronic publication date: 31/08/2018
Collection year: 2018

© 2018 Spiro and Scemons.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to the author at the California State University, Los Angele, USA, Tel: 323343300; E-mail:

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