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The Control of Hypertension In Pregnancy Study pilot trial.

L A Magee1, P von Dadelszen, S Chan

  • 1Department of Medicine, University of British Columbia, Vancouver, Canada. LMagee@cw.bc.ca

BJOG : an International Journal of Obstetrics and Gynaecology
|May 23, 2007
PubMed
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Tight control of nonsevere hypertension in pregnancy significantly lowered diastolic blood pressure (dBP). This pilot trial suggests a larger study is needed to assess effects on maternal and perinatal complications.

Area of Science:

  • Obstetrics and Gynecology
  • Cardiology
  • Clinical Trials

Background:

  • Nonsevere hypertension affects pregnant women.
  • Current management strategies for nonsevere hypertension in pregnancy vary.
  • Understanding optimal blood pressure control is crucial for maternal and fetal outcomes.

Purpose of the Study:

  • To compare 'less tight' versus 'tight' control of nonsevere hypertension in pregnancy.
  • To determine the impact of different blood pressure targets on diastolic blood pressure (dBP).
  • To assess the feasibility and importance of a larger trial on perinatal and maternal complications.

Main Methods:

  • Randomised controlled trial conducted across 17 obstetric centres.
  • Inclusion criteria: pregnant women with dBP 90-109 mmHg, pre-existing or gestational hypertension.

Related Experiment Videos

  • Intervention: Randomisation to less tight (target dBP 100 mmHg) or tight (target dBP 85 mmHg) control.

    • Main Results:

    • Mean dBP was significantly lower with tight control (-3.5 mmHg; 95% CI: -6.4, -0.6).
    • Less tight control was associated with higher rates of antenatal antihypertensive medication use and severe hypertension.
    • No significant differences were observed in serious maternal or perinatal complications between groups.

    Conclusions:

    • The pilot trial demonstrated the feasibility of a larger definitive trial.
    • Tight blood pressure control in nonsevere hypertension during pregnancy resulted in lower dBP.
    • Further research is warranted to confirm the impact on serious maternal and perinatal outcomes.