The blood pressure of a pregnant woman should not exceed 140/90 mm Hg. If the blood pressure values are above this level, it is referred to as high blood pressure during pregnancy. In pregnant woman with hypertension during pregnancy: At what point should antihypertensive drug treatment be initiated? If blood pressure exceeds 140/90 mm Hg? Or if blood pressure exceeds 160/105 mm Hg? That was an open question until 2022.
A randomized controlled clinical trial took place in 2022 and included 2408 women with mild hypertension during pregnancy. The first group received an antihypertensive drug when blood pressure exceeded 140/90 mm Hg. The second group, the control group, received an antihypertensive drug only when blood pressure exceeded 160/105 mm Hg. The primary endpoint of this clinical trial was a composite endpoint. This composite endpoint was complicated but clinically meaningful. It included important clinical outcomes for the mother and the baby.
The result: The incidence of the primary endpoint was 30.2% in the group with active treatment of mild hypertension during pregnancy, compared with 37.0% in the control group. This is a statistically significant and clinically relevant difference in favour of immediate drug treatment of mild hypertension during pregnancy.
Should mild hypertension during pregnancy be treated with medication? We now can answer this question with “Yes.”