Nolasco-Leaños AG, Ramírez-Valenzuela KL, Carrillo-Juárez RI, et al. - An imbalance in angiogenic factors characterize gestational hypertension. Researchers here examined if in women with gestational hypertension, circulating concentrations of proangiogenic and antiangiogenic factors are linked with the risk of progression to preeclampsia and development of adverse outcomes. They grouped 496 women with gestational hypertension into three based on their degree of angiogenic imbalance, evaluated by the soluble fms-like tyrosine kinase-1/placental growth factor ratio: no angiogenic imbalance (≤ 38), mild angiogenic imbalance (> 38–< 85), and severe angiogenic imbalance (≥ 85) or stratified into tertiles according to soluble endoglin (sEng) levels. Higher rates of adverse maternal and perinatal outcomes and progression to preeclampsia were observed among patients with severe angiogenic imbalance when compared with patients with no or mild angiogenic imbalance. Findings suggest a possible value of circulating concentrations of the soluble fms-like tyrosine kinase-1/placental growth factor ratio and sEng at the time of initial evaluation for determining the risk of adverse maternal and perinatal outcomes and progression to preeclampsia in women with gestational hypertension.