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

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 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 ★★★★★☆☆ GP/FP/Obstetrics ★★★★★★☆ Internal medicine ★★★★★★☆ Nephrology ★★★★★★☆ Obstetrics ★★★★★★☆


Embedded ImageData 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).

Embedded ImageStudy selection and assessment:

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

Embedded ImageOutcomes:

severe hypertension, pre-eclampsia, fetal or neonatal death, preterm …

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  • For correspondence: Dr E Abalos, Centro Rosarino de Estudios Perinatales, Rosario, Santa Fe, Argentina. crep{at}

  • Sources of funding: Medical Research Council UK and World Health Organization.