Prescribing for pregnancy: chronic hypertension

An increasing number of women who become pregnant have pre-existing hypertension. For this group of women, a proportion will develop pre-eclampsia or severe hypertension which can impact on maternal and fetal well-being. Women with raised blood pressure should be offered reliable contraception when they do not wish to conceive and pre-conception counselling to address pregnancy-related concerns and advice on preparation for pregnancy and the use of medicines. For women with a history of hypertension, the smallest number of safe medicines at the lowest effective doses should be used while preparing for and during pregnancy. This article forms part of the series of prescribing for pregnancy and discusses the impact of hypertension on pregnancy, the impact of pregnancy on hypertension and options for treatment.