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A 35 year old multiparous woman had essential hypertension, adequately treated since the age of 22. This problem worsened during her three pregnancies, especially in the third trimesters. Recently, induction and delivery were hastened because of hypertension without proteinuria and a healthy infant was delivered. The obstetrician reduced the metoprolol dose postpartum when the blood pressure fell to 140/65. Thirty six hours later the blood pressure started to rise again. Despite efforts to lower this with oral antihypertensives, it climbed steeply to 210/115. The patient remained asymptomatic until she had a disabling pure motor ischaemic stroke …

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