What is the appropriate management of women with chronic hypertension before pregnancy?
Precise estimates of the clinical benefits of antihypertensive therapy in women younger than age 30 with mild to moderate hypertension are not available. Three randomized trials involving 8,565 nongravid women with mild to moderate hypertension, ages 30 to 54, show that approximately 259 (confidence interval [CI] 158 to 1,606) such women would need to be treated for 5 years to prevent a fatal or nonfatal cardiovascular event. No clinical outcome data from trials in nongravid younger women treated for similar or shorter intervals were found. Whether particular blood pressure management strategies that are used prior to conception have beneficial or adverse effects on conception or pregnancy outcomes has not been studied in trials.
