title: The Control of Hypertension In Pregnancy Study pilot trial.
abstract: OBJECTIVE
  To determine whether 'less tight' (versus 'tight') control of nonsevere hypertension results in a difference in diastolic blood pressure (dBP) between groups.
  
  
  METHODS
  Randomised controlled trial (ISRCTN#57277508).
  
  
  METHODS
  Seventeen obstetric centres in Canada, Australia, New Zealand, and UK.
  
  
  METHODS
  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.
  
  
  METHODS
  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%).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, University of British Columbia, Vancouver, Canada. LMagee@cw.bc.ca
authors.forename: L A
authors.initials: LA
authors.lastname: Magee
authors.forename: P
authors.initials: P
authors.lastname: von Dadelszen
authors.forename: S
authors.initials: S
authors.lastname: Chan
authors.forename: A
authors.initials: A
authors.lastname: Gafni
authors.forename: A
authors.initials: A
authors.lastname: Gruslin
authors.forename: M
authors.initials: M
authors.lastname: Helewa
authors.forename: S
authors.initials: S
authors.lastname: Hewson
authors.forename: E
authors.initials: E
authors.lastname: Kavuma
authors.forename: S K
authors.initials: SK
authors.lastname: Lee
authors.forename: A G
authors.initials: AG
authors.lastname: Logan
authors.forename: D
authors.initials: D
authors.lastname: McKay
authors.forename: J-M
authors.initials: JM
authors.lastname: Moutquin
authors.forename: A
authors.initials: A
authors.lastname: Ohlsson
authors.forename: E
authors.initials: E
authors.lastname: Rey
authors.forename: S
authors.initials: S
authors.lastname: Ross
authors.forename: J
authors.initials: J
authors.lastname: Singer
authors.forename: A R
authors.initials: AR
authors.lastname: Willan
authors.forename: M E
authors.initials: ME
authors.lastname: Hannah
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D007741:Labetalol / Q000627:therapeutic use*; D017060:Patient Satisfaction; D010865:Pilot Projects; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000517:prevention & control*; D011256:Pregnancy Outcome; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D007741:Labetalol