Chronic Hypertension
Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults, Updated for the 2023 Edition
O10.0-4/O10.9
GENERAL MEASURES
Lifestyle modification
- No alcohol should be taken.
- Regular moderate exercise, e.g. 30 minutes brisk walking at least 3 times a week.
- Smoking cessation.
- Aim to keep BP <140/90 mmHg.
Screen for end-organ damage.
Foetal surveillance by symphysis-fundus height (SFH) growth. Umbilical artery Doppler screening (where available) at 24-26 weeks.
Ask mother about foetal movements at each antenatal visit.
LoE:IIbxix
Consider labour induction if:
- BP persistently ≥160/110 mmHg, or
- pregnancy of ≥38 weeks duration, or
- in the presence of maternal or foetal compromise, e.g., poor SFH growth and oligohydramnios, etc.
MEDICINE TREATMENT
See prevention and treatment of pre-eclampsia.
Switch ACE-inhibitors and diuretics to methyldopa and/or amlodipine. Women should be advised that there is an increased risk of congenital abnormalities if ACE-inhibitors were taken during pregnancy.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Adult Hospital Level, 2025-9 Review_Version 2.0_26 March 2026
Chapter 6 Obstetrics_6.4 Hypertensive Disorders in Pregnancy_6.4.3 Chronic Hypertension
Drugs mentioned
ICD-10 codes
- O10.0Pre-existing essential hypertension complicating pregnancy, childbirth and the puerperium
- O10.1Pre-existing hypertensive heart disease complicating pregnancy, childbirth and the puerperium
- O10.2Pre-existing hypertensive renal disease complicating pregnancy, childbirth and the puerperium
- O10.3Pre-existing hypertensive heart and renal disease complicating pregnancy, childbirth and the puerperium
- O10.4Pre-existing secondary hypertension complicating pregnancy, childbirth and the puerperium
- O10.9Unspecified pre-existing hypertension complicating pregnancy, childbirth and the puerperium