Treatment of chronic hypertension in pregnancy
●For pregnant patients with nonsevere chronic hypertension (based on medical history or systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg or both on at least two occasions at least four hours apart before 20 weeks of gestation), we recommend antihypertensive treatment (Grade 1B)
Traditionally, only severe chronic hypertension (blood pressure [BP] ≥160/110 mmHg) has been treated in pregnancy because of fetal safety concerns and lack of evidence of maternal benefit. In the Chronic Hypertension and Pregnancy (CHAP) trial, over 2400 pregnant people with nonsevere chronic hypertension (≥140/90 mmHg) were randomly assigned to active treatment (initiating/continuing antihypertensive treatment to keep BP <140/90 mmHg) or usual care (antihypertensive treatment only for BP ≥160/105 mmHg).
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