ACC: Treatment Beneficial for Mild Chronic HTN in Pregnancy

Reduction seen in risk for primary outcome event, with no increased risk for small-for-gestational age birth weight
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TUESDAY, April 5, 2022 (HealthDay News) -- For pregnant women with mild chronic hypertension, treatment with antihypertensive medications recommended for use in pregnancy is associated with improved pregnancy outcomes, according to a study published online April 2 in the New England Journal of Medicine to coincide with the annual meeting of the American College of Cardiology, held from April 2 to 4 in Washington, D.C.

Alan T. Tita, M.D., Ph.D., from the University of Alabama in Birmingham, and colleagues conducted a multicenter, randomized trial involving 2,408 pregnant women with mild chronic hypertension and singleton fetuses at a gestational age of less than 23 weeks. Participants were randomly assigned to receive antihypertensive medications recommended for use in pregnancy to a target blood pressure of less than 140/90 mm Hg or to receive no treatment unless severe hypertension developed (active treatment versus control).

The researchers found that the incidence of a primary outcome event (composite of preeclampsia with severe features, medically indicated preterm birth at less than 35 weeks of gestation, placental abruption, or fetal or neonatal death) was lower in the active-treatment group versus the control group (30.2 versus 37.0 percent; adjusted risk ratio, 0.82). The percentage of small-for-gestational-age birth weights below the 10th percentile was not significantly different between the groups (11.2 and 10.4 percent in the active-treatment and control groups, respectively). The incidence of preeclampsia and preterm birth was significantly lower in the active-treatment group versus the control group (risk ratios, 0.79 and 0.87, respectively).

"The impact of treating chronic hypertension during pregnancy represents a major step forward for supporting people at high risk for adverse pregnancy outcomes," Tita said in a statement.

Several authors disclosed financial ties to the biopharmaceutical industry.

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