What hypertensive disorder is suspected for Ms. Sato, a 19-year-old at 14 weeks' gestation with elevated blood pressures?

In the case of Ms. Sato, who is a 19-year-old at 14 weeks' gestation with elevated blood pressures, chronic hypertension is the most appropriate suspicion. Chronic hypertension is defined as high blood pressure that is present before pregnancy or develops within the first 20 weeks of gestation. Given that Ms. Sato is at an early stage in her pregnancy, particularly only 14 weeks along, the elevated blood pressure is more consistent with a pre-existing condition rather than one that has developed as a direct result of the pregnancy itself, such as gestational hypertension or preeclampsia.

To clarify, gestational hypertension typically occurs after 20 weeks of gestation, making it unlikely for Ms. Sato given her current stage. Preeclampsia, which is characterized by hypertension and often proteinuria, also commonly manifests after 20 weeks of gestation and is generally accompanied by additional signs that develop during the pregnancy. Superimposed preeclampsia would further imply an underlying chronic hypertension progressing into preeclampsia, which again would not be applicable in this scenario since the first signs are appearing so early in the pregnancy.

Thus, chronic hypertension is the most fitting diagnosis for someone with elevated blood pressures appearing