Hypertension in pregnancy: is it time for a new approach to treatment?
Open accessAbstract
Hypertensive disorders represent major causes of pregnancy-related maternal mortality worldwide. The current definition and treatment recommendations for elevated blood pressure (BP) during pregnancy in the United States have remained unchanged for many years, unlike the recommendations for hypertension treatment in the general population. Clinical studies have provided convincing evidence that women with hypertensive pregnancy disorders are at both immediate and long-term risk for cardiovascular complications; these findings suggest that consideration be given to lowering the presently recommended BP thresholds, both for the initiation of therapy and for therapeutic targets, and to simplifying the approach to the management of elevated BP in pregnancy. This review focuses on the current treatment strategies for hypertensive pregnancy disorders, new developments in the field of hypertension, in general, and in pregnant patients, in particular, and their potential impact on contemporary BP goals and the use of specific antihypertensive medications in pregnancy.
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Beta-adrenergic blocking agents have been studied extensively for treating hypertension in pregnancy, and no major side effects have been detected, although fetal growth restriction has been associated with prolonged use of especially atenolol.
“These agents have been studied extensively when used for treating hypertension in pregnancy, and no major side effects have been detected, although fetal growth restriction has been associated with the prolonged use of especially atenolol (431,471).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [471]
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Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000065 · Cited by 7,391 · see citing works
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“These agents have been studied extensively when used for treating hypertension in pregnancy, and no major side effects have been detected, although fetal growth restriction has been associated with the prolonged use of especially atenolol (431,471).”
BackgroundWhelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000596 · Cited by 1,127 · see citing works
Bushnell, C., McCullough, L. D., Awad, I. A., Chireau, M. V., Fedder, W. N., Furie, K. L., Howard, V. J., Lichtman, J. H., Lisabeth, L. D., Piña, I. L., et al. (2014) · Stroke · doi:10.1161/01.str.0000442009.06663.48 · Cited by 941 · see citing works
- Authors
- Moser, M., Brown, C. M., Rose, C. H., & Garovic, V. D.
- Affiliations
- Yale University (US)
- Mayo Clinic (US)
- Corresponding author
- Garovic, Vesna D.
- ORCID
- Garovic, Vesna D.
- Venue
- Journal of Hypertension
- Published
- 2012-06
- Volume
- 30
- Issue
- 6
- Pages
- 1092-1100
- ISSN
- 0263-6352 (ISSN-L)
- PMC
- PMC3746762
- OpenAlex
- W2086901820
- Cited by
- 45
- References
- 66
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 5 · 2017: 5 · 2016: 2 · 2015: 4 · 2014: 8 · 2013: 6 · 2012: 2
- FWCI
- 7.72
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K08HD051714)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
- Keywords
- hypertension in pregnancy, hypertensive disorders of pregnancy, blood pressure thresholds, cardiovascular risk in pregnancy, maternal mortality, blood pressure targets, treatment guidelines
- MeSH terms
- Antihypertensive Agents, Blood Pressure, Female, Humans, Hypertension, Pregnancy, Pregnancy Complications, Cardiovascular
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