Is Antihypertensive Therapy Beneficial for Pregnant Women with Mild Chronic Hypertension?

Optimal management of mild chronic hypertension in pregnancy is uncertain, because no consensus exists on ideal pregnancy blood pressure (BP) targets or thresholds for initiating pharmacotherapy. Pharmacologic blood pressure lowering might improve outcomes, but concerns persist about risk for fetal growth restriction.

This U.S. multicenter, open-label trial included 2400 women with mild chronic hypertension (defined as BP between 140/90 and 160/105 mm Hg) and singleton pregnancies of less than 23 weeks' gestation. Most participants (78%) had prepregnancy hypertension, and most already were taking medication; the other 22% received hypertension diagnoses during early pregnancy. Participants were randomized to active treatment (targeting a BP …