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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

Founded in 1837, MetroHealth is leading the way to a healthier you and a healthier community through service, teaching, discovery, and teamwork. Cuyahoga County’s public, safety-net hospital system, MetroHealth meets people where they are, providing care through five hospitals, four emergency departments and more than 20 health centers. Each day, our nearly 9,000 employees focus on providing our community with equitable healthcare — through patient-focused research, access to care, and support services — that seeks to eradicate health disparities rooted in systematic barriers. For more information, visit