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

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. 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 hypertension (DBP 90–105 mm Hg without medication and 85–105 mm Hg if on...

Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: August, P. Tags: Drugs: cardiovascular system, Stroke, Hypertension, Pregnancy, Renal medicine Therapeutics/Prevention Source Type: research