Deshmukh US, Lundsberg LS, Culhane JF, et al. - As per recommendations from the American College of Obstetricians and Gynecologists (ACOG), pregnant patients should be provided expeditious treatment with first-line antihypertensive agents within 1 hour of confirmed severe hypertension to reduce the risk of maternal stroke. Researchers herein investigated the factors linked with receiving guideline-concordant treatment for obstetric hypertensive emergency via performing a case-control study of pregnant and postpartum patients who had persistent severe hypertension (≥ 2 systolic blood pressures (BP) ≥ 160 mmHg and/or diastolic BP ≥ 110 mmHg within 1 hour of each other) during their delivery hospitalization. They assessed a total of 39,918 deliveries, 1,987 of these (5.0%) were complicated by severe persistent obstetric hypertension. Per findings, recommended antihypertensive treatment was not provided to nearly half of obstetric patients with at least two documented severely elevated blood pressures. Among those who did receive treatment, nearly 40% received delayed treatment. Likelihood of receiving recommended treatment was higher in correlation with Black and Hispanic race and preterm gestation, compared with White race and term pregnancies. Lower likelihood of receiving any first-line antihypertensive treatment was recorded for patients whose severe obstetric hypertension occurred overnight and those who were postpartum. Overall, treatment was less likely among patients without sociodemographic and clinical risk factors for severe obstetric hypertension or other pregnancy complications. However, there appeared a significant improvement in treatment over time with implementation of targeted quality measures and specific institutional policies based on ACOG’s latest sHTN management guidelines.