However, the accuracy and reliability of screening will be improved, reducing the need for further investigations for some women and correctly identifying more women who need further testing or investigations. Moving from 24-hour urine collection to spot urine ACR or PCR will save time, with potential for faster diagnosis, and a reduction in inaccuracies because of incomplete samples. It is also likely to improve quality of life, as the process of completing a 24-hour urine collection is time-consuming and awkward. A PCR of 30 mg/mmol is already used routinely as a diagnostic threshold and therefore should not change practice. Currently units may use different ACR levels for diagnosis and so the recommendation to use 8 mg/mmol will standardise practice. Recommendations have been made for the use of either ACR or PCR allowing local decisions to use whichever test is available, so this should not affect practice. Repeating the PCR or ACR test may incur a small additional cost. However, this should reduce the false positive rate, and mean some women will avoid unnecessary follow-up or intensive monitoring (such as hospital admission) if their proteinuria resolves and is shown to be transient. Full details of the evidence and the committee's discussion are in evidence review G: assessment of proteinuria. Return to recommendations Treatment of chronic hypertension Why the committee made the recommendations The committee agreed that pregnant woman with chronic hypertension should be offered lifestyle advice similar to other adults with hypertension, and in line with the NICE guideline on hypertension in adults. There was very little evidence available on treatment initiation thresholds for chronic hypertension in pregnancy, so the committee based their recommendations on the values specified in the recent Control of Hypertension in Pregnancy Study (CHIPS) and the NICE guideline on hypertension in adults. 