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  • Lowering diastolic blood pressure in non-proteinuric hypertension in pregnancy is not harmful to the fetus and is associated with reduced frequency of severe maternal hypertension

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Therapeutics/Prevention
Randomised controlled trial
Lowering diastolic blood pressure in non-proteinuric hypertension in pregnancy is not harmful to the fetus and is associated with reduced frequency of severe maternal hypertension
  1. Phyllis August
  1. Department of Medicine—Nephrology and Hypertension, Weill Cornell Medical Center, New York, New York, USA
  1. Correspondence to : Dr Phyllis August, Department of Medicine—Nephrology and Hypertension, Weill Cornell Medical Center, 424 East 70th Street, New York, NY 1002, USA; paugust{at}med.cornell.edu

https://doi.org/10.1136/ebmed-2015-110203

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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.OpenUrlCrossRefPubMed

    Context

    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.

    Methods

    This open, multicentre trial included 987 pregnant women with mild to moderate …

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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.