The American College of Obstetrics and Gynecology (ACOG) recommends the initiation of anti hypertensive agents when the blood pressure exceeds 160/110 mm Hg in patients with preeclampsia. This recommendation is based on a case series showing that stokes typically occur in patients with preeclampsia when systolic blood pressure is >155 mmHg. Furthermore, a recent Cochrane review on blood pressure managment in preeclampsia did not demonstrate additional benefit of aggressive blood pressure lowering.