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Women's Health

Chronic Hypertension in Pregnancy: A New Standard of Care

Published: May 16, 2022

Chronic hypertension (CHTN) – or elevated blood pressure prior to or in the early stages of pregnancy – is one of the most common medical issues facing expectant women. And new information is suggesting a more aggressive treatment approach, which could result in better outcomes for Mom and Baby.


The CHAP Study

CHTN puts mothers and babies at risk for many complications, including preeclampsia – which is high blood pressure that results from pregnancy and can lead to serious, sometimes fatal problems.

For years, pregnant women with CHTN were treated with the goal of keeping their blood pressures in the mild range (anything less than 160 over anything less than 110). There was some concern that overtreating high blood pressure could lead to fetal complications.

Thanks to the CHAP (Chronic Hypertension and Pregnancy) study, which was published in April 2022, we now know that a healthy blood pressure for most pregnant women is anything less than 140 over anything less than 90. In fact, the study showed that tighter blood pressure control didn’t increase the risk of fetal side effects and actually reduced the risk for preeclampsia as well as:

  • Placental abruption
  • Preterm birth
  • Neonatal death
  • Stillbirth

A New Standard of Care

Factoring in this new standard of care, CHTN treatment may include:

  • Regular blood pressure monitoring (at home and/or in the clinic)
  • Blood pressure medication
  • The addition of a low-dose aspirin
  • Frequent monitoring of Baby’s growth
  • Fetal well-being monitoring in the third trimester of pregnancy

Of course, high blood pressure isn’t the only threat to expectant women. More information continues to surface about the impacts of COVID-19 on pregnancy and its link to preeclampsia. Talk to your provider about getting vaccinated and ask how the CHAP study may translate to your specific care plan.

More Resources

About the Author

As a maternal-fetal medicine specialist, Emily Patel, MD, FACOG, is most inspired by the women and families she cares for. She has seen and experienced the gamut of her specialty, including the joy of bringing a rainbow baby into the world and the heart-wrenching loss of a newborn or stillborn baby.

“Having the chance to help a family through a difficult and challenging pregnancy is a privilege,” she said. “While there are many difficult days, there are also times I get to celebrate a good pregnancy outcome, and that gives me so much joy!”

She attended medical school and completed her residency at the University of Nebraska Medical Center. She also completed a fellowship in maternal-fetal medicine at Duke University. 

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