In a nutshell
This study investigated the safety and effectiveness of oral antihypertensive drugs (OAHDs) in pregnancy.
They found that OAHDs reduced blood pressure (BP) in most women.
Some background
Hypertension or high blood pressure (BP) is a common condition. It is also the most common disorder diagnosed in pregnancy. Hypertension during pregnancy is dangerous. It can lead to complications including pre-eclampsia (PEP). PEP can be life threatening to the mother. Severe hypertension can also lead to negative pregnancy outcomes. It can lead to preterm delivery, stunted growth and death of the baby.
Only certain anti-hypertensive drugs can be used during pregnancy. Most of these are administered intravenously. This requires hospitalization and fetal monitoring. In some countries, resources are not available to provide this level of care. Oral antihypertensive drugs (OAHDs) are also available. It is unclear if OAHDs are safe and effective in pregnant women.
Methods & findings
This study included 894 pregnant women with severe hypertension. Severe hypertension was BP greater than 160/110 mmHg. Women were randomly assigned to treatment with one of three drugs. These were nifedipine retard (Adalat), labetalol (Normodyne) or methyldopa (Aldomet). The main outcome was a reduction in BP with no severe side effects.
More women achieved BP control with nifedipine (84%) compared to methyldopa (76%). There was no significant difference in the BP control rates of nifedipine and labetalol-treated patients or between the labetalol and methyldopa-treated patients. Women treated with methyldopa were more likely to need a second OAHD to manage BP.
Headache and rapid heart rate were side effects of nifedipine. Pregnancy outcomes were similar across all groups. Low birth rate was more common in nifedipine-treated patients.
The bottom line
The authors concluded that OAHDs were safe and effective in most pregnant women.
The fine print
This study was conducted in two hospitals in India. The standards of care may differ in other countries.
What’s next?
If you have any concerns regarding hypertension please consult with your doctor.
Published By :
Lancet (London, England)
Date :
Aug 01, 2019
