This trial is evaluating whether Treatment will improve 9 secondary outcomes in patients with Hypertension, Pregnancy-Induced. Measurement will happen over the course of From the date of randomization through date of death from any cause, assessed up to 6 weeks postpartum.
This trial requires 200 total participants across 2 different treatment groups
This trial involves 2 different treatments. Treatment is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are in Phase 4 and have been shown to be safe and effective in humans.
There are significant signs of pregnancy-related hypertension. These include high blood pressure as detected by examination, low blood pressure during pregnancy, and fetal growth restriction. More research into the natural history of gestational hypertension is needed to more thoroughly assess the role of the risk factors.
In the United States, the rate of stroke in elderly women is 2- to 5-fold higher than that of men. Pregnancy-induced hypertension increases risk of stroke in women younger than 50 years.
The major limitation of our study is that it was a cross sectional study carried out at a tertiary hospital, which can be a bias. The study was based on retrospective data which can make some generalisations difficult.
In women who become pregnant the risk of developing hypertension increases. The cause is likely to be related to a combination of factors in the fetus and during pregnancy.
Treatments for hypertension in pregnancy are based on lifestyle change and are dependent on the indication for which the treatment is prescribed. Medications such as nifedipine and amlodipine, antiadrenoceptor agents and nitric oxide are commonly used in pregnancy. In addition to conventional and alternative approaches, acupuncture and alternative medicines may be used. Knowledge of which treatments are used is an important aspect of comprehensive management.
About 31% of women (n = 1.7 million) report hypertension, pregnancy-induced in the previous year. Although hypertension is recognized as an important risk factor for poor cardiovascular outcomes, it is possible that women with diabetes are at greater risk for pregnancy-induced hypertension when compared to women without diabetes. The effect of obesity on this risk appears to depend on the presence of diabetes.
Hypertension affects more than 2 million pregnant women in the United States. Studies of the benefits of exercise for postnatal hypertension are small, have poor methodological quality, and are of low-quality evidence. No evidence suggests that exercise plus dietary changes have any advantages over dietary advice alone, although some studies suggest a small beneficial effect. This review lists the best available evidence.
The present review confirms that the therapeutic use of the antihypertensive drug tolbutamide in pregnancy is still the main treatment for hypertension in pregnancy. For therapeutic use, the data from recent clinical trials support the idea that tolbutamide may be particularly effective compared to other drugs. But despite these advances, many women with tolbutamide-induced hypertension in pregnancy are still not treated.
[Hypertension should be considered in pregnancy for all women irrespective of their risk of developing CHD or stroke. The majority of these women will not benefit. Patients with risk factors for hypertension and CHD, preeclampsia and/or severe pre-existing hypertension should be offered more rigorous treatment for these diseases with the provision of alternative therapies in case of treatment failure. Clinical trials conducted in hospitals on a large scale need a long-term commitment from physicians and institutional authorities. It is therefore appropriate to conduct clinical trials in low-risk women under close supervision in low-risk settings.
The average age of people diagnosed with hypertension is 48 yr in Canada and 65 yr in the US, and pregnancies induced earlier may affect the incidence of preeclampsia. The highest average age of diagnosis was found among women with diabetes and hypertension.
A single-blind treatment with low-dose amlodipine was well tolerated, with treatment-related reductions in blood pressure and a placebo-adjusted 12-step walking distance. Longitudinal data will be published soon.
Although hypertension is common, most women will not require medications to treat HTN during pregnancy. Pregnant women have increased risk for HTN, therefore antihypertensive medication should be initiated early and continued even after the birth. We are not able to estimate if or when the need for medications in postpartum is the same. There still is no good evidence to recommend medication in the postpartum period to decrease HTN, which can be very dangerous in preeclampsia. Only good quality research can provide us this evidence.