Although definitions of severe hypertension vary, thresholds of ≥160-170 mm Hg systolic and/or ≥110 mm Hg diastolic are in most common usage. A recent focus has been placed on systolic hypertension given the increased pulse pressure in these women. In pregnancy, there is a general consensus that severe hypertension should be treated. Among woman with pre-eclampsia, attention must be paid to other end organ dysfunction, as blood pressure (BP) management is but one aspect of care. The urgency of antihypertensive therapy will depend primarily on the absolute level of BP. However, most clinicians will also consider both the rate of BP rise and the presence of maternal symptoms. Most commonly, severe hypertension is treated with parenteral labetalol or hydralazine, or oral nifedipine (capsules or PA tablet). Other options will depend on local availability. MgSO4 should not be relied on as an antihypertensive.
⁎Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
†Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
‡Centre for Applied Health Research and Evaluation, Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
§Department of Health Care and Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada
Address reprint requests to Laura A. Magee, MD, MSc, FRCPC, FACP, BC Women's Hospital and Health Centre, 4500 Oak Street, Room 1U59, Vancouver, BC V6P 1S8, Canada
ABSTRACT