Clinical Research Directory

Inclusion Criteria: * Age 18 or older * Patients with a viable pregnancy \<23 weeks of gestation * Chronic hypertension is defined as: 1) Currently receiving treatment for hypertensive disorders OR 2) Newly diagnosed or untreated chronic hypertension is defined as systolic blood pressure \>=140 mm Hg or diastolic blood pressure \>=90 mm Hg prior to 20 weeks of gestation * Viable pregnancy \<23 weeks of gestation * Ability to follow directions * Ability to consent * Speak English or Spanish Exclusion Criteria: * Known secondary cause of hypertension * Known major fetal anomaly * Known fetal demise * Suspected fetal growth restriction * Membrane rupture * Planned termination * Plan to deliver outside of the RWJ Barnabas Health system * Known sensitivity to labetalol or nifedipine * Unlikely to follow up, in the opinion of the study staff. * Any medical condition that the providers feel is a contraindication to the REACH algorithm. * Unwillingness to take blood pressure at home