Treatment for Mild Chronic Hypertension during Pregnancy

To the Editor: In their article on the Chronic Hypertension and Pregnancy (CHAP) trial, Tita et al. (May 12 issue)(1) report better pregnancy outcomes in women assigned to active treatment of mild chronic hypertension (blood-pressure goal, <140/90 mm Hg) than in those assigned to treatment only for severe hypertension, with no increase in adverse fetal outcomes. We infer from data in Tables S2 and S4 in the Supplementary Appendix (available with the full text of the article at NEJM.org) that in order to achieve the observed difference in blood pressure between the trial groups, labetalol was withdrawn in at least . . .

Automated summary

The study suggests that active treatment for mild chronic hypertension in pregnant women leads to better pregnancy outcomes, while treatment only for severe hypertension does not increase the risk of adverse fetal outcomes.