Level of BP Control for Non-Severe Hypertension Didn't Affect Pregnancy Outcomes

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Level of BP Control for Non-Severe Hypertension Didn't Affect Pregnancy Outcomes
Level of BP Control for Non-Severe Hypertension Didn't Affect Pregnancy Outcomes

(HealthDay News) — When pregnant women have non-severe hypertension, more intensive treatment doesn't seem to affect their babies, but it may lower the odds that mothers will develop severe hypertension, according to a clinical trial published in the New England Journal of Medicine.

The findings are based on 987 pregnant women from 16 different countries who had hypertension. Half were randomly assigned to "tight" blood pressure (BP) control, and half to "less tight." 

For the tight-control group, the goal was to get their diastolic pressure to 85 mm Hg or lower; for the less-tight group, the goal was 100 mm Hg or lower. Treatment involved regular BP checks and, for most women, medication — with the dose adjusted when needed. 

Most of the women took labetalol.

Laura Magee, MD, of the Child and Family Research Institute and the University of British Columbia in Vancouver, Canada, and colleagues found no significant between-group differences in the risk for pregnancy loss, high-level neonatal care, or overall maternal complications. 

However, 40.6% of women under looser BP control eventually developed severe hypertension, while just 27.5% of women on the tighter regimen developed severe hypertension.

Magee told HealthDay that she believes the risk for severely high numbers is not acceptable if less-intensive treatment has no clear benefit for babies. 

"Before this study, I was for less-tight control," she noted. "Now I've changed my practice." 

Until now, studies on this issue have been small or lower-quality, according to Magee. She said current professional guidelines vary because of that lack of strong evidence.

Reference

  1. Magee LA et al. N Engl J Med. 2015;372:407-417.
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