Pregnant patients should be started on antihypertensive therapy if the systolic blood pressure >160 mmHg or the diastolic blood pressure >100-105 mmHg. Treatment of high blood pressure in pregnancy is indicated when the potential benefit of treatment justifies the potential risk. Commonly used first-line agents include: Methyldopa (alpha blocker), labetalol (beta-blocker), or nifedipine (calcium channel blocker). Second-line agents include metoprolol (beta-blocker) or atenolol (beta-blocker). Third-line agents may be used if other medications are not tolerated and include clonidine (alpha-agonist) or intravenous Hydralazine for severe hypertension (vasodilator).
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