This protocol applies to gestational hypertension arising de novo at or after 20 weeks' gestation, where blood pressure remains non-severe — systolic below 160 mmHg and diastolic below 110 mmHg — in the absence of proteinuria or other features of pre-eclampsia.
De novo hypertension at ≥20 weeks' gestation without proteinuria or pre-eclampsia features. Hypertension in pregnancy is defined as clinic systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg; non-severe hypertension has systolic below 160 mmHg and diastolic below 110 mmHg.
A target diastolic BP of 85 mmHg, regardless of the systolic reading.
First-line management uses oral antihypertensive monotherapy, titrated toward the diastolic target. The specific agents, selection criteria, and titration algorithm are set out in the full protocol.
Complete drug selection, sequencing, and monitoring are available via the link below.
Hypertension arising de novo at ≥ 20 weeks' gestation in the absence of proteinuria or other findings suggestive of pre-eclampsia.
Hypertension in pregnancy continues to be defined as a clinic sBP ≥ 140 mmHg and/or a dBP ≥ 90 mmHg, with sBP ≥ 160 mmHg and/or a dBP ≥ 110 mmHg defined as severe hypertension.
Hypertension in pregnancy should be treated with antihypertensive therapy, irrespective of the underlying HDP (⊕⊕⊕O/Strong).
Non-severe hypertension should be treated with the first-line agents oral methyldopa, labetalol, or nifedipine (⊕⊕⊕O/Strong).
Initial antihypertensive therapy for non-severe hypertension in pregnancy should be monotherapy from the listed first-line drugs, based on small, randomised trials.
The target BP for antihypertensive therapy should be a dBP of 85 mmHg, regardless of sBP (⊕⊕⊕⊕/Strong).
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