In my apprenticeship, we had a client who twice had chronic hypertension, controlled with meds. The first time we attended her, she went off her meds and her bp was like 160/120 in labor, so we transported. The second time she had a waterbirth (WATER IS SO GREAT FOR HYPERTENSION!!!) and it was beautiful.
I do know that epidurals lower your bp, so sometimes there is a push to get one.