Oral combined hydrochlorothiazide and lisinopril vs nifedipine for postpartum hypertension: a comparative-effectiveness pilot randomized controlled trial

Bartal, Michal Fishel; Blackwell, Sean C.; Pedroza, Claudia; Lawal, Daramoye; Amro, Farah H.; Samuel, Joyce P.; Chauhan, Suneet P.; Sibai, Baha M.

doi:10.1016/j.ajog.2023.01.015

Cited by 6 publications

(3 citation statements)

References 46 publications

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“…Home BP monitoring has been used to facilitate research on postpartum antihypertensive medications in two recent RCTs—a trial of furosemide compared with placebo 46 and a trial of combined hydrochlorothiazide and lisinopril compared with nifedipine. 47 A substantial percentage of patients with HDP continued to require antihypertensive medications to maintain BP lower than 140/90 mm Hg at 6 weeks, including 32.6% of patients with preeclampsia with severe features, 23.8% of patients with preeclampsia without severe features, and 16.1% of patients with gestational hypertension. 48 Thus, many individuals may benefit from longer-duration home BP monitoring with medication titration and lifestyle educational interventions.…”

Section: Discussionmentioning

confidence: 99%

Postpartum Home Blood Pressure Monitoring

Steele,

Adam,

Saldanha

et al. 2023

Obstetrics &Amp; Gynecology

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OBJECTIVE: To assess the effectiveness of postpartum home blood pressure (BP) monitoring compared with clinic-based follow-up and the comparative effectiveness of alternative home BP–monitoring regimens. DATA SOURCES: Search of Medline, Cochrane, EMBASE, CINAHL, and ClinicalTrials.gov from inception to December 1, 2022, searching for home BP monitoring in postpartum individuals. METHODS OF STUDY SELECTION: We included randomized controlled trials (RCTs), nonrandomized comparative studies, and single-arm studies that evaluated the effects of postpartum home BP monitoring (up to 1 year), with or without telemonitoring, on postpartum maternal and infant outcomes, health care utilization, and harm outcomes. After double screening, we extracted demographics and outcomes to SRDR+. TABULATION, INTEGRATION, AND RESULTS: Thirteen studies (three RCTs, two nonrandomized comparative studies, and eight single-arm studies) met eligibility criteria. All comparative studies enrolled participants with a diagnosis of hypertensive disorders of pregnancy. One RCT compared home BP monitoring with bidirectional text messaging with scheduled clinic-based BP visits, finding an increased likelihood that at least one BP measurement was ascertained during the first 10 days postpartum for participants in the home BP–monitoring arm (relative risk 2.11, 95% CI 1.68–2.65). One nonrandomized comparative study reported a similar effect (adjusted relative risk [aRR] 1.59, 95% CI 1.36–1.77). Home BP monitoring was not associated with the rate of BP treatment initiation (aRR 1.03, 95% CI 0.74–1.44) but was associated with reduced unplanned hypertension-related hospital admissions (aRR 0.12, 95% CI 0.01–0.96). Most patients (83.3–87.0%) were satisfied with management related to home BP monitoring. Home BP monitoring, compared with office-based follow-up, was associated with reduced racial disparities in BP ascertainment by approximately 50%. CONCLUSION: Home BP monitoring likely improves ascertainment of BP, which is necessary for early recognition of hypertension in postpartum individuals, and may compensate for racial disparities in office-based follow-up. There is insufficient evidence to conclude that home BP monitoring reduces severe maternal morbidity or mortality or reduces racial disparities in clinical outcomes. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42022313075.

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Section: Discussionmentioning

confidence: 99%

Postpartum Home Blood Pressure Monitoring

Steele,

Adam,

Saldanha

et al. 2023

Obstetrics &Amp; Gynecology

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“…The treatment of MetS consists of administering antihypertensive drugs, lipid-lowering medications, antidiabetic medicines, and a combination of a healthy diet and physical activity. Current therapeutic regimens for hypertension include the administration of ARBs such as losartan [ 43 ], ACE inhibitors like lisinopril [ 44 ], or calcium channel blockers such as amlodipine [ 45 ].…”

Section: Mets: An Overview About Its Epidemiology Oxidative Stress An...mentioning

confidence: 99%

Recent Advances in the Therapeutic Potential of Carotenoids in Preventing and Managing Metabolic Disorders

Ortega-Regules,

Martínez-Thomas,

Schürenkämper-Carrillo

et al. 2024

Plants

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Carotenoids constitute compounds of significant biological interest due to their multiple biological activities, such as antimicrobial, anticancer, antiadipogenic, antidiabetic, and antioxidant properties. Metabolic syndrome (MetS) comprehends a series of metabolic abnormalities (e.g., hypertension, obesity, and atherogenic dyslipidemia) that can affect children, adolescents, and the elderly. The treatment of MetS involves numerous medications, which, despite their efficacy, pose challenges due to prolonged use, high costs, and various side effects. Carotenoids and their derivatives have been proposed as alternative treatments to MetS because they reduce serum triglyceride concentrations, promote insulin response, inhibit adipogenesis, and downregulate angiotensin-converting enzyme activity. However, carotenoids are notably sensitive to pH, light exposure, and temperature. This review addresses the activity of carotenoids such as lycopene, lutein, fucoxanthin, astaxanthin, crocin, and β-carotene towards MetS. It includes a discussion of sources, extraction methods, and characterization techniques for analyzing carotenoids. Encapsulation approaches are critically reviewed as alternatives to prevent degradation and improve the biological performance of carotenoids. A brief overview of the physiopathology and epidemiology of the diseases, including MetS, is also provided.

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“…CVDs are deemed to be the main reason for death, including stroke, ischemic cardiomyopathy, and atherosclerosis [ 2 ]. Today, many effective medicines have been used in treating MetS and CVDs, such as hydrochlorothiazide and nifedipine, which are used as first-line drugs to reduce blood pressure [ 3 ]; metformin is effective in treating hyperglycemia [ 4 ]. However, the continuous use of these treatments may cause adverse reactions such as dyspnea, dizziness, vertigo, headaches, and muscle lysis [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect and Mechanism of Oleanolic Acid in the Treatment of Metabolic Syndrome and Related Cardiovascular Diseases

Luo,

Wei,

et al. 2024

Molecules

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Metabolic syndromes (MetS) and related cardiovascular diseases (CVDs) pose a serious threat to human health. MetS are metabolic disorders characterized by obesity, dyslipidemia, and hypertension, which increase the risk of CVDs’ initiation and development. Although there are many availabile drugs for treating MetS and related CVDs, some side effects also occur. Considering the low-level side effects, many natural products have been tried to treat MetS and CVDs. A five-cyclic triterpenoid natural product, oleanolic acid (OA), has been reported to have many pharmacologic actions such as anti-hypertension, anti-hyperlipidemia, and liver protection. OA has specific advantages in the treatment of MetS and CVDs. OA achieves therapeutic effects through a variety of pathways, attracting great interest and playing a vital role in the treatment of MetS and CVDs. Consequently, in this article, we aim to review the pharmacological actions and potential mechanisms of OA in treating MetS and related CVDs.

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Oral combined hydrochlorothiazide and lisinopril vs nifedipine for postpartum hypertension: a comparative-effectiveness pilot randomized controlled trial

Cited by 6 publications

References 46 publications

Postpartum Home Blood Pressure Monitoring

Postpartum Home Blood Pressure Monitoring

Recent Advances in the Therapeutic Potential of Carotenoids in Preventing and Managing Metabolic Disorders

The Effect and Mechanism of Oleanolic Acid in the Treatment of Metabolic Syndrome and Related Cardiovascular Diseases

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