Tight systolic blood pressure control early in pregnancy improves pregnancy outcomes in women with chronic hypertension

Objectives: To clarify the effects of tight blood pressure control on pregnancy outcomes. Methods: This retrospective study included 38 cases of singleton pregnancies which were diagnosed with essential hypertension either before pregnancy or during the first trimester of pregnancy. Patients were subdivided according to systolic blood pressure ( < 130 mmHg, 130–139 mmHg, ≥ 140 mmHg) between 8–11, 12–15, and 16–19 weeks’ gestation, respectively. The influence of systolic blood pressure in each gestational period was assessed with regard to the risk of preterm birth, foetal growth restriction, and superimposed preeclampsia. Results: At 16–19 weeks’ gestation, systolic blood pressure ≥ 140 mmHg and in the range of 130–139 mmHg was strongly linked to a shorter gestational period and lower z-scores for birth weight. The incidence of early onset superimposed preeclampsia was lower in women who had systolic blood pressure < 130 mmHg at 16–19 weeks’ gestation (11%) compared with those with a systolic blood pressure of 130–139 mmHg (27%) and ≥ 140 mmHg (75%). Conclusions: Tight control of blood pressure, with a target systolic blood pressure <