Gestational hypertension is a disease specific to pregnancy, referred to as gestational hypertension, characterized by hypertension, edema, proteinuria, convulsions, coma, cardiac and renal failure, and even death of mother and child. The prevalence of gestational hypertension accounts for 5-10% of pregnant women, 70% of which are hypertensive related to pregnancy, and the remaining 30% have hypertension before pregnancy. Gestational hypertensive syndrome is classified as mild, moderate or severe according to its severity. Severe gestational hypertensive syndrome is also known as pre-eclampsia and eclampsia, and eclampsia means that there are convulsions on top of hypertension. This disease is a serious threat to the health of mother and child, once detected, it should be given sufficient attention and treated early. The diagnosis of the disease can be made by monitoring blood pressure greater than 140/90. Now, we will discuss the treatment considerations of hypertension in pregnancy with the latest guidelines. The main purpose of treatment of hypertensive disorders in pregnancy is to ensure the safety of mother and child and the smooth progress of pregnancy. Similar to common hypertensive disorders, for hypertension in pregnancy, the first step should be non-pharmacological measures, such as salt restriction, potassium-rich diet, appropriate activity, and emotional relaxation, which are safe and effective treatments for combined hypertension in pregnancy and should be used as the basis for pharmacological treatment. The antihypertensive medication during pregnancy should not be too aggressive, because the safety of all antihypertensive drugs on the fetus lacks strict clinical verification, and some drugs have been found to have teratogenic effects in animal tests, so the selection and application of drugs are limited, which also brings difficulties to clinical treatment. The treatment strategy, duration of administration and choice of drugs depend on the degree of BP elevation and the assessment of the risks associated with it. In patients with gestational hypertension, pharmacological treatment should be initiated after non-pharmacological measures, when the blood pressure is ≥150/100 mmHg, and when the therapeutic goal is below 150/100 mmHg, with the goal of controlling the blood pressure to 130-140/80-90 mmHg. The specific treatment strategies are as follows: first, for mild gestational hypertension: pharmacological treatment does not provide benefit to the fetus, nor does it provide any benefit to the fetus. fetal benefit and there is no evidence to prevent the development of pre-eclampsia. Non-pharmacological treatment, including salt restriction, is the safest and effective management at this time. During the first 20 weeks of pregnancy, the patient’s blood pressure may return to normal due to reduced systemic vascular tone. With continued nonpharmacologic treatment, antihypertensive medications can be discontinued. In patients with pre-pregnancy hypertension, presence of target organ damage or simultaneous use of multiple antihypertensive drugs, drug doses should be adjusted according to blood pressure levels during pregnancy, in principle using the fewest possible drug classes and doses, and patients should be fully informed of the uncertainty of the effects of early pregnancy medication on the development of vital fetal organs. In preeclampsia with mildly elevated blood pressure, since the incidence of eclampsia is only 0.5%, routine application of magnesium sulfate is not recommended, but close observation of blood pressure and urine protein changes as well as fetal condition is needed. Secondly, the main goal of treatment for severe combined hypertension in pregnancy is to minimize the prevalence and morbidity and mortality of the mother. The duration of treatment, antihypertensive goals, drug selection, and indications for termination of pregnancy should be defined under close observation of maternal and infant status. For severe preeclampsia, intravenous application of magnesium sulfate is recommended, close observation of blood pressure, key reflexes and adverse reactions, and determination of the timing of termination of pregnancy. Second, the choice of antihypertensive drugs for hypertension in pregnancy The choice of antihypertensive drugs for hypertension in pregnancy requires strict caution. The most commonly used oral drugs are labetalol, methyldopa and nifedipine, and small doses of thiazide diuretics can be considered when necessary. ACEI and ARB are contraindicated during pregnancy, and the above drugs should also be discontinued in patients with chronic hypertension who have a pregnancy plan. For patients with previous pregnancy with hypertension, chronic kidney disease, autoimmune disease, diabetes mellitus, chronic hypertension, and a combination of ≥1 risk factor for preeclampsia (primigravida, >40 years of age, >10 years between pregnancies, BMI >35, family history of preeclampsia, multiple pregnancies), low-dose aspirin (75-100 mg/d) is recommended from 12 weeks of gestation until one week before delivery . Magnesium sulfate is the drug of choice for the treatment of severe preeclampsia. When lowering blood pressure, it is important not to speak too low, as this can trigger an inadequate blood supply to the fetus and cause adverse events.