Placebo-controlled Trial of Atenolol in Treatment of Pregnancy-associated Hypertension

Rubin, Peter C.; Clark, Donald C.; Sumner, D. J.; Low, R. A. L.; Butters, L; Reynolds, Brian D.; Steedman, D J; Reid, John L.

doi:10.1097/00006254-198308000-00006

Cited by 25 publications

(46 citation statements)

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“…This study of 120 women found no differences in the frequency of IUGR, neonatal hypoglycemia and hyperbilirubinemia between the two groups. [12] The follow up of 120 children at 1 year of age following the use of atenolol or placebo in the last trimester of pregnancy also showed no adverse effects on development. [13] Whereas the treatment of mild to moderate hypertension in pregnancy with atenolol did not affect maternal mortality, it did reduce the incidence of subsequent pre-eclampsia, hospital admission and respiratory distress syndrome in the neonate.…”

Section: β-Blockersmentioning

confidence: 92%

“…Initially, atenolol was a popular drug of choice and it was shown to be of benefit in late pregnancy in a placebo-controlled trial in patients with mild-moderate hypertension. [12] Treatment with atenolol reduced proteinuria and the number of hospital admissions. This study of 120 women found no differences in the frequency of IUGR, neonatal hypoglycemia and hyperbilirubinemia between the two groups.…”

Section: β-Blockersmentioning

confidence: 99%

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Management of Hypertension in Pregnancy

Chung

Beevers

Lip

2001

American Journal of Cardiovascular Drugs

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Hypertension is an important cause of both maternal and fetal morbidity and mortality in pregnant women. There are still no definitive guidelines as to when and how patients should be treated, but it is important that appropriate treatment is initiated early in patients at highest risk and they are closely monitored. Hypertension in pregnancy can be a difficult condition to diagnose and treat because of the numerous and differing classification systems that have been used in the past. One classification system, which accounts for the multisystem involvement which can occur in pre-eclampsia and eclampsia, divides hypertension in pregnancy into 3 main groups: pre-eclampsia, gestational hypertension and chronic hypertension. Little benefit to the fetus has been shown from treating gestational and chronic hypertension, but studies in this area have been small and would not have had the power to show a difference in outcome between treated and untreated groups. However, the reduction in morbidity and mortality in the treatment of pre-eclampsia is significant. Therefore, all pregnancies complicated by hypertension require monitoring to detect the possible onset of superimposed pre-eclampsia/eclampsia. Institutions should have a management strategy for those mothers with severe hypertension including a multidisciplinary approach, where the patient is to be monitored and which antihypertensive agents are to be used. It should not be forgotten that the definitive treatment for severe hypertension is delivery of the fetus despite risks to fetal morbidity and mortality. This will reduce blood pressure, but hypertension per se may still persist post partum requiring short term therapy.

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Section: β-Blockersmentioning

confidence: 92%

Section: β-Blockersmentioning

confidence: 99%

Management of Hypertension in Pregnancy

Chung

Beevers

Lip

2001

American Journal of Cardiovascular Drugs

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“…There is decreased incidence of respiratory distress syndrome (RDS) in neonates. Unfortunately, β-blockers have been associated with increased SGA infants and bradycardia [27][28][29]. The follow-up of 120 children at 1 year of age following the use of atenolol in the last trimester of pregnancy showed no adverse effects on development compared with placebo [30].…”

Section: β-Blockersmentioning

confidence: 99%

Hypertension in pregnancy

Mugo

Govindarajan

Kurukulasuriya

et al. 2005

Current Science Inc

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Hypertension in pregnancy contributes significantly to both maternal and neonatal morbidity and mortality. Among different forms of pregnancy-associated hypertension, preeclampsia-eclampsia has the highest impact on morbidity and mortality. Chronic hypertension may result in preterm and small for gestational age infants, even when it is mild-to-moderate. Chronic hypertension is a risk factor for superimposed preeclampsia and results in higher rates of adverse outcome. Preeclampsia is a multisystemic disease that is thought to be initiated by abnormalities in placental perfusion and endothelial dysfunction, ultimately resulting in multiorgan failure. Preeclampsia is more common in women of minority ethnicity who are socioeconomically disadvantaged. Pharmacologic therapy for hypertensive disorders in pregnancy is limited by concerns regarding the safety of both mother and fetus. Although treatment of severe hypertension is not debated, there is no consensus on the rationale for pharmacologic therapy of mild-to-moderate hypertension in pregnancy.

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“…Concerns have been raised about the potential for intrauterine growth retardation with β-blockers [37], although some placebo-controlled studies with atenolol and metoprolol have failed to demonstrate this relationship [38,39]. A more recent study reported growth retardation in babies receiving atenolol in the first trimester [40], suggesting that the dosing of β-blocker during the first trimester is the main determinant of intrauterine growth retardation.…”

Section: Class II (Beta Adenergic Blocking Agents)mentioning

confidence: 99%

Antiarrhythmic drugs in pregnancy

Joglar

Page

2001

Current Opinion in Cardiology

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During pregnancy a number of rhythm disturbances can occur in both the mother and fetus; these may range from benign ectopy to life-threatening arrhythmias. With a clear understanding of the maternal hemodynamic changes associated with pregnancy, and the appropriate antiarrhythmic therapies available, almost all such cases can be treated successfully. Although no drug is completely safe, most are well tolerated and can be given with relatively low risk. Drug therapy should be avoided during the first trimester of pregnancy if possible and drugs with the longest record of safety should be used as first-line therapy. Conservative therapies should be used when appropriate. Several drug options exist for most maternal and fetal arrhythmias.

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Placebo-controlled Trial of Atenolol in Treatment of Pregnancy-associated Hypertension

Cited by 25 publications

References 0 publications

Management of Hypertension in Pregnancy

Management of Hypertension in Pregnancy

Hypertension in pregnancy

Antiarrhythmic drugs in pregnancy

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