Placebo-Controlled Trial of Atenolol in Treatment of Pregnancy-Associated Hypertension

Rubin, Peter C.; Clark, DonaldM.; Sumner, D. J.; Low, RobertA.; Butters, L; Reynolds, Brian D.; Steedman, D J; Reid, J L

doi:10.1016/s0140-6736(83)91436-8

Cited by 98 publications

(33 citation statements)

References 20 publications

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“…In contrast to the above findings, atenolol and labetalol prevented proteinuria in the treatment group as compared to the control group. [101][102][103] RCTs with methyldopa pointed to better pregnancy outcome in cases of mild PIH and mild PE with regard to mid-pregnancy abortions and progression to severe PE, respectively. 104,105 Another trial of methyldopa in mild PIH demonstrated a significant prolongation of pregnancy, by about 10.3 days, with no adverse effect on birth weight.…”

Section: Follow-upmentioning

confidence: 96%

Pregnancy-Induced hypertension

et al. 2015

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pregnancy-induced hypertension (pIh) complicates 6-10% of pregnancies. It is defined as systolic blood pressure (sbp) >140 mmhg and diastolic blood pressure (dbp) >90 mmhg. It is classified as mild (sbp 140-149 and dbp 90-99 mmhg), moderate (sbp 150-159 and dbp 100-109 mmHg) and severe (SBP ≥160 and DBP ≥110 mmHg). PIH refers to one of four conditions: a) pre-existing hypertension, b) gestational hypertension and preeclampsia (pe), c) pre-existing hypertension plus superimposed gestational hypertension with proteinuria and d) unclassifiable hypertension. pIh is a major cause of maternal, fetal and newborn morbidity and mortality. women with pIh are at a greater risk of abruptio placentae, cerebrovascular events, organ failure and disseminated intravascular coagulation. fetuses of these mothers are at greater risk of intrauterine growth retardation, prematurity and intrauterine death. ambulatory blood pressure monitoring over a period of 24 h seems to have a role in predicting deterioration from gestational hypertension to pe. antiplatelet drugs have moderate benefits when used for prevention of pe. treatment of pIh depends on blood pressure levels, gestational age, presence of symptoms and associated risk factors. non-drug management is recommended when sbp ranges between 140-149 mmhg or dbp between 90-99 mmhg. blood pressure thresholds for drug management in pregnancy vary between different health organizations. according to 2013 esh/esc guidelines, antihypertensive treatment is recommended in pregnancy when blood pressure levels are ≥150/95 mmHg. Initiation of antihypertensive treatment at values ≥140/90 mmHg is recommended in women with a) gestational hypertension, with or without proteinuria, b) pre-existing hypertension with the superimposition of gestational hypertension or c) hypertension with asymptomatic organ damage or symptoms at any time during pregnancy. methyldopa is the drug of choice in pregnancy. atenolol and metoprolol appear to be safe and effective in late pregnancy, while labetalol has an efficacy comparable to methyldopa. angiotensin-converting enzyme (ace) inhibitors and angiotensin II antagonists are contraindicated in pregnancy due to their association with increased risk of fetopathy.

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Section: Follow-upmentioning

confidence: 96%

Pregnancy-Induced hypertension

et al. 2015

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“…Although several randomized trials comparing ␤-blockers with either placebo or other agents have been conducted, 31,32,42,43 there are still some unresolved issues regarding their use in pregnancy, largely a result of a few small studies that suggest an association with lower birth weight infants. None of the ␤-blockers have been associated with teratogenicity.…”

Section: Peripherally Acting Adrenergicmentioning

confidence: 99%

Update on the Use of Antihypertensive Drugs in Pregnancy

2008

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“…Many patients who have hypertension during pregnancy can be controlled on a single agent such as a ,8-adrenoceptor blocker (Thorley et al, 1981;Rubin, 1981;Rubin et al, 1983) or methyldopa (Redman et al, 1976). When additional treatment is required this usually takes the form of a vasodilator such as hydralazine (Gallery et al, 1979) or prazosin (Lubbe & Hodge, 1981 Prazosin concentration was measured in whole (AUCO1) and blood using the high pressure liquid chromatography obtained in I method previously described .…”

Section: Introduction Methodsmentioning

confidence: 99%

Clinical pharmacological studies with prazosin during pregnancy complicated by hypertension.

Rubin¹,

Butters²,

Low³

et al. 1983

Brit J Clinical Pharma

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I The disposition and effect of orally administered prazosin have been studied in eight women with hypertension which was uncontrolled by /8-adrenoceptor blockade during the last trimester of pregnancy. Results were compared with healthy men of similar age. 2 The median time to peak concentration was 165 min during pregnancy and 120 min in the men (P < 0.04). Area under the concentration vs time curve was 3914 ng 1-' min in pregnancy and 2439 ng l-I min in the men (P < 0.06). Mean elimination half-life was 171 min in the pregnant women and 130 min in the men (P < 0.01). 3 Blood pressure was lowered by prazosin in both supine and standing positions. Blood pressure control remained satisfactory in six of the eight women and the median prolongation of pregnancy was 22 days. Neonatal outcome was satisfactory and all babies are developing normally. 4 We conclude that prazosin is more slowly, but apparently more completely, absorbed during pregnancy and that its half-life is slightly prolonged. Prazosin appears to be both effective and safe when used during the last trimester to control blood pressure.

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Placebo-Controlled Trial of Atenolol in Treatment of Pregnancy-Associated Hypertension

Cited by 98 publications

References 20 publications

Pregnancy-Induced hypertension

Pregnancy-Induced hypertension

Update on the Use of Antihypertensive Drugs in Pregnancy

Clinical pharmacological studies with prazosin during pregnancy complicated by hypertension.

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