Review: drugs for mild to moderate hypertension in pregnancy reduce the risk of severe hypertension but not pre-eclampsia

doi:10.1136/ebm.12.4.116

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Evidence-Based Medicine 2007;12:116; doi:10.1136/ebm.12.4.116
Copyright © 2007 by the BMJ Publishing Group Ltd.

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Therapeutics

Review: drugs for mild to moderate hypertension in pregnancy reduce the risk of severe hypertension but not pre-eclampsia

Abalos E, Duley L, Steyn D, et al. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev 2007;(1):CD002252.[Medline]

Q In pregnant women with mild to moderate hypertension, what are the benefits and risks of antihypertensive (anti-HT) drugs? Is one type of anti-HT drug better than another?

Clinical impact ratings GP/FP/Primary care $*$ $*$ $*$ $*$ $*$ ${star}$ ${star}$ GP/FP/Obstetrics $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Internal medicine $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Nephrology $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ Obstetrics $*$ $*$ $*$ $*$ $*$ $*$ ${star}$

The first 150 words of the full text of this article appear below.

METHODS
Data sources: Cochrane Pregnancy and Childbirth Group’s Trials Register(March 2006); Cochrane Central Register of Controlled Trials(2005, issue 3); and Medline, LILACS, and EMBASE/Excerpta Medica(to November 2005).

Study selection and assessment: randomised controlled trials (RCTs) that evaluated any anti-HTdrug (compared with placebo or no anti-HT drug [control] oranother type of anti-HT drug) for mild to moderate hypertensionduring pregnancy. Quasi-randomised studies and those involvingtreatment for <7 days were excluded. 46 RCTs met the selectioncriteria: 28 RCTs compared anti-HT drugs with control (n = 3200)and 19 RCTs compared 2 types of anti-HT drugs (n = 1282).

Outcomes: severe hypertension, pre-eclampsia, fetal or neonatal death,preterm birth, and small for gestational age (SGA) infants.

MAIN RESULTS
Most trials were of moderate to poor quality. Meta-analysisshowed that anti-HT drugs reduced severe hypertension more thancontrol (table), but groups did not differ for pre-eclampsia,fetal or neonatal . . . [Full text of this article]

Laura A Magee, MD

University of British Columbia,
Vancouver, British Columbia, Canada