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New Study Shows Treating Preexisting High Blood Pressure in Pregnancy Improves Maternal and Fetal Outcomes

Kelly Gibson, MD

The MetroHealth System participated in a new study that shows that treating chronic high blood pressure with medications is beneficial and safe for the mom and baby. The findings provide for the first time comprehensive, evidence-based data for treating non-severe forms of chronic hypertension during pregnancy.

More than 2% of pregnant women in the United States have chronic hypertension, or high blood pressure. Healthcare professionals agree that severe chronic hypertension during pregnancy should be treated with medications.  However, whether to treat mild forms of chronic hypertension during pregnancy has led to a divide in medical recommendations for decades.

The Chronic Hypertension and Pregnancy trial, or CHAP, was funded by the National Heart, Lung, and Blood Institute. The randomized trial compared treating patients with mild chronic hypertension with medication versus no medications and evaluated the effects on maternal and fetal health.

The study results showed that treatment with medications improved pregnancy outcomes without compromising the baby’s growth and overall health.

“As high-risk pregnancy providers, we have known for decades that high blood pressure increases the risk of pregnancy complications, yet it was not clear whether using a medication would lower this risk or cause other problems.  With these study results, we now have an answer,” said Kelly Gibson, MD, Director of Maternal Fetal Medicine and the site Principal Investigator of the study for MetroHeath. “The CHAP study shows us that treating patients with mild hypertension is safer for moms and does not increase complications for babies.”

Chronic hypertension increases the risk for pregnancy complications, including maternal and perinatal death. The condition is associated with a three- to five-times increased risk for preeclampsia, placental abruption, preterm birth, small for gestational age newborns and perinatal death. High blood pressure is also associated with a five- to 10-times increased risk for maternal death, heart failure, stroke, pulmonary edema and acute kidney injury.

Black mothers are disproportionately affected by chronic high blood pressure, so they consisted of almost 50% of the participants.

MetroHealth was one of more than 60 clinical sites for the study. The link to the full study can be found in the New England Journal of Medicine.

About the MetroHealth System

The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it.

The system’s more than 600 doctors, 1,700 nurses and 7,800 employees go to work each day with a mission of service, to their patients and to the community. As Cuyahoga County’s safety-net health system, MetroHealth plays an essential role in the region, caring for anyone and everyone, regardless of an ability to pay.

Founded in 1837, MetroHealth operates four hospitals, four emergency departments and more than 20 health centers throughout Cuyahoga County. The system serves more than 300,000 patients, three-quarters of whom are uninsured or covered by Medicare or Medicaid.

MetroHealth is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and Ohio’s only adult and pediatric trauma and burn center. 

As an academic medical center, MetroHealth is committed to research and to teaching and training tomorrow’s caregivers. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine. Its main campus hospital houses the Cleveland Metropolitan School District’s Lincoln-West School of Science & Health, the only high school in America located inside a hospital.

Knowing that good health is about much more than good medical care, MetroHealth has launched the Institute for H.O.P.E.™ (Health, Opportunity, Partnership, Empowerment), which uses a coordinated, collaborative and strategic approach to help patients with non-medical needs such as healthy food, stable housing and job training.

The MetroHealth Glick Center, a new 11-floor hospital, is under construction on the system’s main campus in Cleveland and is scheduled to welcome its first patients in October 2022. The billion-dollar project is the cornerstone of a wider neighborhood revitalization effort led by the system and its partners in the community.

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