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Commentary on: Magee LA, von Dadelszen P, Rey E, et al. Less-tight versus tight control of hypertension in pregnancy. N Engl J Med 2015;372:407–17.
Guidelines recommend lowering blood pressure (BP) below 140/90 mm Hg in adults <60 years to prevent cardiovascular complications.1 During pregnancy, lowering BP below 160/110 mm Hg is universally endorsed; however, maternal and fetal benefits of targets below 140/90 mm Hg are not clear. Some meta-analyses suggest a possible reduction in fetal birth weight associated with lowering mildly elevated BP.2 However, other analyses found no evidence of fetal harm and a reduction in severe maternal hypertension.3 This clinical trial compared fetal and maternal outcomes associated with lowering diastolic BP (DBP) to 100 mm Hg compared to 85 mm Hg in non-proteinuric hypertensive pregnant women.
This open, multicentre trial included 987 pregnant women with mild to moderate hypertension (DBP 90–105 mm Hg without medication and 85–105 mm Hg if on …
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