CHIPS
Control of Hypertension In Pregnancy Study
Patient / Population Intervention / Exposition Vergleich Endpunkt
In 987 pregnant women with non-proteinuric pre-existing or gestational hypertension, less-tight blood-pressure control did not reduce pregnancy loss or high-level neonatal care compared with tight control targeting a diastolic pressure of 85 mmHg, but led to far more severe maternal hypertension.
N
987
Design
Open-label, international RCT
Endpunkt
Composite of pregnancy loss or high-level neonatal care for more than 48 hours
Relevanz
2
Ergebnis31.4 % vs 30.7 % (adjusted OR 1.02; 95 % CI 0.77–1.35), but severe hypertension developed in 40.6 % vs 27.5 % (p<0.001).
Magee LA, von Dadelszen P, Rey E, et al. N Engl J Med. 2015;372(5):407-417. 10.1056/NEJMoa1404595
Diskussion & Kritik
Open-label, underpowered for serious maternal complications, and it enrolled largely after 14 weeks, so it cannot address whether earlier treatment prevents pre-eclampsia — the question CHAP later answered. Its lasting contribution is a safety signal in reverse: tight control did not harm the fetus and halved severe hypertension.