Chronic Hypertension and Pregnancy Project
During pregnancy, chronic hypertension (CHTN) is the most common major medical disorder encountered, occurring in 2-6%. Often overlooked, the substantial negative effect of CHTN on pregnancy includes a consistent 3- to 5-fold increase in superimposed preeclampsia and adverse perinatal outcomes (fetal or neonatal death, preterm birth -PTB, poor fetal growth and placental abruption) and possibly a 5- to10-fold increase in maternal cardiovascular and other complications (death, cerebrovascular accident, pulmonary edema and acute renal failure). Mild CHTN (BP <160/110) contributes to a large proportion of these adverse outcomes. While antihypertensive treatment of CHTN is standard for the general population (to reduce death and severe cardiovascular and renal complications), it is uncertain whether treatment during pregnancy reduces maternal or fetal complications, and there are concerns that decreased arterial pressure may reduce fetal blood flow and cause poor fetal growth or small-for-gestational-age (SGA) infants. This study is a multicenter randomized controlled clinical trial of 4700 women with randomization stratified by center to determine if antihypertensive therapy to a standardized BP goal <140/90, for mild CHTN will reduce the frequency of key adverse maternal and perinatal outcomes associated with CHTN.
Dr. Lorraine Dugoff