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The Control of Hypertension In Pregnancy Study pilot trial.
BJOG. 2007 Jun; 114(6):770, e13-20.BJOG

Abstract

OBJECTIVE

To determine whether 'less tight' (versus 'tight') control of nonsevere hypertension results in a difference in diastolic blood pressure (dBP) between groups.

DESIGN

Randomised controlled trial (ISRCTN#57277508).

SETTING

Seventeen obstetric centres in Canada, Australia, New Zealand, and UK.

POPULATION

Inclusion: pregnant women, dBP 90-109 mmHg, pre-existing/gestational hypertension; live fetus(es); and 20-33(+6) weeks. Exclusion: systolic blood pressure > or = 170 mmHg and proteinuria, contraindication, or major fetal anomaly.

METHODS

Randomisation to less tight (target dBP, 100 mmHg) or tight (target dBP, 85 mmHg) blood pressure control.

MAIN OUTCOME MEASURES

Primary: mean dBP at 28, 32 and 36 weeks. Secondary: clinician compliance and women's satisfaction. Other: serious perinatal and maternal complications.

RESULTS

A total of 132 women were randomised to less tight (n = 66; seven had no study visit) or tight control (n= 66; one was lost to follow up; seven had no study visit). Mean dBP was significantly lower with tight control: -3.5 mmHg, 95% credible interval (-6.4, -0.6). Clinician compliance was 79% in both groups. Women were satisfied with their care. With less tight (versus tight) control, the rates of other treatments and outcomes were the following: post-randomisation antenatal antihypertensive medication use: 46 (69.7%) versus 58 (89.2%), severe hypertension: 38 (57.6%) versus 26 (40.0%), proteinuria: 16 (24.2%) versus 20 (30.8%), serious maternal complications: 3 (4.6%) versus 2 (3.1%), preterm birth: 24 (36.4%) versus 26 (40.0%), birthweight: 2675 +/- 858 versus 2501 +/- 855 g, neonatal intensive care unit (NICU) admission: 15 (22.7%) versus 22 (34.4%), and serious perinatal complications: 9 (13.6%) versus 14 (21.5%).

CONCLUSION

The CHIPS pilot trial confirms the feasibility and importance of a large definitive trial to determine the effects of less tight control on serious perinatal and maternal complications.

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Authors+Show Affiliations

Magee LA
Department of Medicine, University of British Columbia, Vancouver, Canada. LMagee@cw.bc.ca
von Dadelszen P
No affiliation info available
Chan S
No affiliation info available
Gafni A
No affiliation info available
Gruslin A
No affiliation info available
Helewa M
No affiliation info available
Hewson S
No affiliation info available
Kavuma E
No affiliation info available
Lee SK
No affiliation info available
Logan AG
No affiliation info available
McKay D
No affiliation info available
Moutquin JM
No affiliation info available
Ohlsson A
No affiliation info available
Rey E
No affiliation info available
Ross S
No affiliation info available
Singer J
No affiliation info available
Willan AR
No affiliation info available
Hannah ME
No affiliation info available
CHIPS Pilot Trial Collaborative Group
No affiliation info available

MeSH

AdultAntihypertensive AgentsBlood PressureFemaleHumansHypertensionLabetalolPatient SatisfactionPilot ProjectsPregnancyPregnancy Complications, CardiovascularPregnancy OutcomeTreatment Outcome

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17516972

Citation

Magee, L A., et al. "The Control of Hypertension in Pregnancy Study Pilot Trial." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 114, no. 6, 2007, pp. 770, e13-20.
Magee LA, von Dadelszen P, Chan S, et al. The Control of Hypertension In Pregnancy Study pilot trial. BJOG. 2007;114(6):770, e13-20.
Magee, L. A., von Dadelszen, P., Chan, S., Gafni, A., Gruslin, A., Helewa, M., Hewson, S., Kavuma, E., Lee, S. K., Logan, A. G., McKay, D., Moutquin, J. M., Ohlsson, A., Rey, E., Ross, S., Singer, J., Willan, A. R., & Hannah, M. E. (2007). The Control of Hypertension In Pregnancy Study pilot trial. BJOG : an International Journal of Obstetrics and Gynaecology, 114(6), 770, e13-20.
Magee LA, et al. The Control of Hypertension in Pregnancy Study Pilot Trial. BJOG. 2007;114(6):770, e13-20. PubMed PMID: 17516972.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Control of Hypertension In Pregnancy Study pilot trial. AU - Magee,L A, AU - von Dadelszen,P, AU - Chan,S, AU - Gafni,A, AU - Gruslin,A, AU - Helewa,M, AU - Hewson,S, AU - Kavuma,E, AU - Lee,S K, AU - Logan,A G, AU - McKay,D, AU - Moutquin,J-M, AU - Ohlsson,A, AU - Rey,E, AU - Ross,S, AU - Singer,J, AU - Willan,A R, AU - Hannah,M E, AU - ,, PY - 2007/5/23/pubmed PY - 2007/6/8/medline PY - 2007/5/23/entrez SP - 770, e13-20 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 114 IS - 6 N2 - OBJECTIVE: To determine whether 'less tight' (versus 'tight') control of nonsevere hypertension results in a difference in diastolic blood pressure (dBP) between groups. DESIGN: Randomised controlled trial (ISRCTN#57277508). SETTING: Seventeen obstetric centres in Canada, Australia, New Zealand, and UK. POPULATION: Inclusion: pregnant women, dBP 90-109 mmHg, pre-existing/gestational hypertension; live fetus(es); and 20-33(+6) weeks. Exclusion: systolic blood pressure > or = 170 mmHg and proteinuria, contraindication, or major fetal anomaly. METHODS: Randomisation to less tight (target dBP, 100 mmHg) or tight (target dBP, 85 mmHg) blood pressure control. MAIN OUTCOME MEASURES: Primary: mean dBP at 28, 32 and 36 weeks. Secondary: clinician compliance and women's satisfaction. Other: serious perinatal and maternal complications. RESULTS: A total of 132 women were randomised to less tight (n = 66; seven had no study visit) or tight control (n= 66; one was lost to follow up; seven had no study visit). Mean dBP was significantly lower with tight control: -3.5 mmHg, 95% credible interval (-6.4, -0.6). Clinician compliance was 79% in both groups. Women were satisfied with their care. With less tight (versus tight) control, the rates of other treatments and outcomes were the following: post-randomisation antenatal antihypertensive medication use: 46 (69.7%) versus 58 (89.2%), severe hypertension: 38 (57.6%) versus 26 (40.0%), proteinuria: 16 (24.2%) versus 20 (30.8%), serious maternal complications: 3 (4.6%) versus 2 (3.1%), preterm birth: 24 (36.4%) versus 26 (40.0%), birthweight: 2675 +/- 858 versus 2501 +/- 855 g, neonatal intensive care unit (NICU) admission: 15 (22.7%) versus 22 (34.4%), and serious perinatal complications: 9 (13.6%) versus 14 (21.5%). CONCLUSION: The CHIPS pilot trial confirms the feasibility and importance of a large definitive trial to determine the effects of less tight control on serious perinatal and maternal complications. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/17516972/The_Control_of_Hypertension_In_Pregnancy_Study_pilot_trial_ L2 - https://doi.org/10.1111/j.1471-0528.2007.01315.x DB - PRIME DP - Unbound Medicine ER -