Regardless of its origin, high BP during pregnancy is associ- ated with risk to both mother and baby, and BP-related com- plications remain a leading cause of maternal morbidity and mortality, as well as preterm birth, fetal growth restriction, and Women with high BP during pregnancy who have given birth continue to be at risk for preeclampsia and stroke. Although less common than preeclampsia during pregnancy, postpartum preeclampsia is more insidious and potentially more dangerous, because women may be unaware of its development and are no longer being seen regularly, as they were for prenatal care. Postpartum preeclampsia is associated with a high risk for stroke and may be the underlying cause of severe postpartum headaches.152 Transient elevations in BP are common post partum because of volume redistribution, iatro- genic administration of fluid, alterations in vascular tone, and use of nonsteroidal anti-inflammatory drugs,153 155 but persis- tently elevated BP should be categorized and treated accord- ing to the adult guidelines.140 A 2010 Cochrane review noted that the RR of hyperten- sion in pregnancy was decreased with calcium supplementa- A reduction in preeclampsia/eclampsia was also noted (RR, 0.45; 95% CI, 0.31 0.65). Low-dose aspirin can also lower the risk for preeclampsia, on the basis of a meta-analysis of 46 tri- als and 32891 women (RR, 0.83; 95% CI, 0.77 0.89; number needed to treat, 72).157 Recent research suggests that vita- min D3 deficiency may be associated with increased risk for but there are insufficient data to support a recommendation. Treatment of Elevated BP During Pregnancy, Including Preeclampsia The central autoregulatory plateau in pregnancy is estimated at 120 mmHg, and women with moderate to severe high BP in pregnancy, especially those with preeclampsia, are at risk for loss of central cerebral vascular autoregulation. 