B4263 - Are blood pressure BP thresholds and variability related to pregnancy outcomes - 28/02/2023

B number: 
Principal applicant name: 
Laura A. Magee | King's College London (United Kingdom)
Milly Willson, PhD candidate
Title of project: 
Are blood pressure (BP) thresholds and variability related to pregnancy outcomes?
Proposal summary: 

(1) Blood Pressure Variability
Outside pregnancy, how much blood pressure varies is associated with the risk of heart attack, stroke, and further health problems. In the CHIPS Trial (Control of Hypertension in Pregnancy Study), of 987 women with high blood pressure that was there before pregnancy or that developed in pregnancy, we found that the more blood pressure varied, the greater the risks for the mother, with possible reduced risks for the baby. We are seeking to confirm whether these findings can be confirmed in another group of patients.

(2) Blood Pressure Thresholds
During pregnancy, high blood pressure (diagnosed when the top number [‘systolic’] is 140mmHg or more, or the bottom number [‘diastolic’] is 90mmHg or more) is associated with more risks for the mother (such as early birth or Caesarean delivery) and for the baby (such as restricted growth). Recent research has indicated that a lower cut-off of 130/80mmHg for high BP may identify more mothers and babies at risk during pregnancy. In this study, we aim to confirm if these findings can be replicated in another group of women.

Impact of research: 
For the BP variability and pregnancy outcome relationship, clinicians will be interested in a new predictive tool, in which BP values can be entered into an mHealth application to stratify risk during pregnancy. For the BP thresholds component, the research aims to add to the growing body of evidence evaluating whether adopting a new lower cut-off for pregnancy hypertension (i.e., 130/80mmHg), can better identify women and babies at risk of adverse outcomes, with global implications.
Date proposal received: 
Saturday, 18 February, 2023
Date proposal approved: 
Tuesday, 28 February, 2023
Clinical research/clinical practice, Hypertension, Statistical methods, Offspring