Table 2.
Aspects/recommendations | WHO 2021 [9] | ISH 2020 [10] | ESC/ESH 2018 [2] | ACC/AHA 2017 [3]a | Latin American 2016 [11] | NICE 2019 [https://www.nice.org.uk/guidance/ng133]b | Australian 2016 [29]c | Japanese 2019 [34] | Chinese 2018 [33] | Korean 2018 [30–32] |
---|---|---|---|---|---|---|---|---|---|---|
Definition of hypertension in pregnancy (mmHg) | ≥140/90 | ≥140/90 | ≥140/90 | ≥140/90 | ≥140/90 | ≥140/90 | ≥140/90 | ≥140/90 | NR | ≥140/90 |
Classification of hypertensive disorders in pregnancy | √ | √ | √ | √ | NR | √ | √ | √ | √ | √ |
Aspirin to prevent preeclampsia in high-risk pregnancy | NR |
Yes, 75–162 mg 12th week |
Yes, 100–150 mg 12th week |
Yes, 60–80 mg late 1st trimester |
Yes, 100 mg, before 6th week |
Yes, 75–150 mg 12th week |
Yes, low dose | NR | Yes, low dose, 12th week | NR |
Treatment of severe hypertension | √ | √ | √ | √ | √ | √ | √ | √ | √ | √ |
Treatment of non-severe hypertension | If comorbidities | √ | √ | No | No | √ | Individualize | No | √ | √ |
On-treatment BP target of severe hypertension (mmHg) | NR | NR | NR | 140–150/90–99 | NR | 130–150/80–100 | NR | <160/110 | NR |
<150/100 Not <80 |
BP threshold to initiate drug treatment in non-severe hypertension (mmHg) |
≥160/105 Diastolic >90 (if comorbidities) |
>150/95 |
>150/95 or >140/90 if comorbidities |
<160/110 only if comorbidities | ≥160/110 | ≥140/90 | ≥140/90 | NR | ≥150/100 | >150/95 |
On-treatment BP target of mild hypertension (mmHg) | NR | NR | <140/90 | NR | NR |
<135/85 Not <110/70 |
NR | NR |
<150/100 Not <130/80 |
<150/100 Not <80 |
Preferred agent(s) to treat severe hypertension | NR |
iv labetalol iv esmolol iv urapidiliv nicardipine |
iv labetalol po nifedipine |
iv hydralazine po nifedipine |
NR |
iv labetalol po nifedipine iv hydralazine |
iv labetalol po nifedipine iv hydralazine |
iv nicardipine iv nitroglycerin iv hydralazine |
NR | iv labetalol |
Preferred agents to treat non-severe hypertension |
po labetalol po nifedipine po verapamil po methyldopa po hydralazine |
po labetalol po nifedipine po nicardipine po methyldopa |
po labetalol po calcium channel blockers |
po labetalol |
po labetalol po methyldopa po nifedipine po amlodipine |
po labetalol po methyldopa po nifedipine po enalaprilb |
po labetalol po methyldopa po nifedipine po oxprenolol |
po labetalol po methyldopa po nifedipined po hydralazinee |
po labetalol po methyldopa po nifedipine |
po labetalol po methyldopa po nifedipine |
BP blood pressure, NR not reported.
a2013 American College of Obstetricians and Gynecologists’ guideline.
bTo treat hypertension during puerperium.
c2014 Society of Obstetric Medicine of Australian and New Zealand (SOMANZ) guideline.
dAfter the 20th week.
eAs an alternative agent in gestational hypertension.