The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice

•This updates the 2018 ISSHP guidelines, and feedback is invited (info@isshp.org).•Angiogenic imbalance is uteroplacental dysfunction when definingpre-eclampsia.•Use multivariable models to estimate the risk of developing pre-eclampsia.•Use aspirin from early pregnancy to halve the risk of preterm pre-eclampsia.•Use multivariable models to estimate the risk of pre-eclampsia complications.•Treat hypertension to a target diastolic BP of 85 mmHg, before or after birth.