Gestational hypertension means high blood pressure during pregnancy. In some people, gestational hypertension can lead to preeclampsia, a serious health condition that causes high blood pressure. However, both are distinct conditions.

People can have hypertension before or during pregnancy. Typically, pregnancy-induced hypertension causes a rise in blood pressure in the second half of pregnancy. It affects 10% of pregnancies.

Preeclampsia is a pregnancy-related condition that causes high blood pressure. It affects 3.4% of pregnancies in the United States.

“Eclampsia” refers to the convulsions that can be associated with severe preeclampsia. It affects 0.3% of people globally.

In this article, we explain the link between gestational hypertension and preeclampsia, looking at some similarities and differences between both conditions.

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While both gestational hypertension and preeclampsia involve an increase in blood pressure after week 20 of pregnancy, there are a few key differences between them.

The table below outlines some of these differences:

Gestational hypertensionPreeclampsia
usually causes no harm to birthing parent or infantcan be life threatening to birthing parent and infant
can cause low birth weight or preterm birth in severe casesmay cause organ damage in birthing parent
only starts during pregnancy and after week 20, and usually goes away within 12 weeks of the birthtypically starts during pregnancy and after week 20, but most commonly in the third trimester and rarely after the birth

Telling them apart

That said, in some people, gestational hypertension can develop into preeclampsia.

The American College of Obstetricians and Gynecologists (ACOG) says that someone has gestational hypertension when they:

  • have a systolic blood pressure of at least 140 mm Hg, a diastolic blood pressure of at least 90 mm Hg, or both
  • first experience high blood pressure after 20 weeks of pregnancy
  • had normal blood pressure before pregnancy

Diagnosing hypertension requires two readings of at least 140 mm Hg systolic or at least 90 mm Hg diastolic, 4 hours (or more) apart.

Mild preeclampsia has the potential to become severe.

Learn more about how doctors might diagnose preeclampsia here.

Symptoms may differ:

Gestational hypertension symptoms

Other than a high blood pressure reading, a person with gestational hypertension usually will not have any other symptoms.

Preeclampsia symptoms

Conversely, the symptoms of preeclampsia that accompany a high blood pressure reading may include:

  • nausea and vomiting (in the second half of pregnancy)
  • pain in the upper abdomen or shoulder
  • swelling of the face or hands
  • a headache that will not go away
  • sudden weight gain
  • seeing spots or changes in eyesight
  • difficulty breathing

However, some people develop preeclampsia and are unaware they have it.

If a person’s condition worsens, they can develop severe preeclampsia. Symptoms of severe preeclampsia include:

  • systolic blood pressure of at least 160 mm Hg or diastolic blood pressure of at least 110 mm Hg
  • pain in the upper abdomen
  • severe headache
  • abnormal kidney or liver function
  • a low platelet count, which can cause problems with blood clotting
  • fluid in the lungs
  • changes in vision

Rarely, preeclampsia symptoms do not start until after birth, which is known as postpartum preeclampsia.

As mentioned above, someone with gestational hypertension is at risk of developing preeclampsia. Additionally, having gestational hypertension can increase the risk of developing hypertension in the future.

Severe preeclampsia can lead to complications. These can include:

  • preterm birth
  • poor fetal growth, resulting from a lack of oxygen and nutrients
  • low birth weight
  • placental abruption, which means the placenta has separated from the uterus
  • stillbirth or pregnancy loss
  • damage to organs and blood systems, including the kidneys, liver, and brain
  • increased risk of heart disease in the birthing parent
  • eclampsia, which means severe preeclampsia is affecting brain function and causing seizures or coma
  • hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, which is a rare and serious complication of preeclampsia or eclampsia resulting from damage to the liver and blood cells

An OB-GYN can check a person’s blood pressure at each prenatal care visit. It is important for a person to attend all their doctors’ appointments so their care team can closely monitor their blood pressure.

If a person experiences any of the above symptoms of preeclampsia during pregnancy, especially after week 20, they should contact their OB-GYN immediately.

To limit complications that could negatively affect the fetus, a person can talk with a healthcare professional about all their options, which may include inducing labor early.

A person with gestational hypertension has high blood pressure during pregnancy. Preeclampsia, a serious medical condition, may play a role in gestational hypertension.

Having gestational hypertension means the birthing parent has a blood pressure reading of 140/90 mm Hg or above from week 20 of pregnancy. They do not usually have other symptoms.

If a person develops preeclampsia, however, they may experience symptoms such as swelling of the hands and face, persistent headache, or abdominal pain. In severe cases, a person may experience symptoms such as blood clotting problems or liver and kidney damage.

Complications of severe preeclampsia can include preterm birth, stillbirth, and HELLP syndrome.