SynthesisThe Cochrane database of systematic reviews2001
Antihypertensive drug therapy for mild to moderate hypertension during pregnancy.
Synthesis in The Cochrane database of systematic reviews, 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 95 citations in OpenAlex.
- Antihypertensive drug therapy for mild to moderate hypertension during pregnancy.The Cochrane database of systematic reviews · 2018Pooled it
- Trial
- Pre-eclampsia.Nature reviews. Disease primers · 2023Review
- Neuro-obstetrics: A multidisciplinary approach to care of women with neurologic disease.Handbook of clinical neurology · 2020Review
- Vitamin D Enhances Efficacy of Oral Nifedipine in Treating Preeclampsia with Severe Features: A Double Blinded, Placebo-Controlled and Randomized Clinical Trial.Frontiers in pharmacology · 2017Article
- The management of hypertension in pregnancy.Advances in chronic kidney disease · 2013Review
- Effect of pregnancy on the pharmacokinetics of antihypertensive drugs.Clinical pharmacokinetics · 2009Review
- Intracerebral hemorrhage: a life-threatening complication of hypertension during pregnancy.Journal of clinical hypertension (Greenwich, Conn.) · 2007Review
- A review of the methodological features of systematic reviews in maternal medicine.BMC medicine · 2007Review
- Management of pre-eclampsia.BMJ (Clinical research ed.) · 2006Review
- Recent developments in obstetrics.BMJ (Clinical research ed.) · 2003Review
- Antihypertensive therapy in pregnancy.Current hypertension reports · 2001Review
- Use of antihypertensive medications in pregnancy and the risk of adverse perinatal outcomes: McMaster Outcome Study of Hypertension In Pregnancy 2 (MOS HIP 2).BMC pregnancy and childbirth · 2001Article
Corrections and comments
- Updated by
Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMild-moderate hypertension during pregnancy is common. Antihypertensive drugs are often used in the belief that lowering blood pressure will prevent progression to more severe disease, and thereby improve outcome.
objectivesTo assess the effects of antihypertensive drug treatments for women with mild to moderate hypertension during pregnancy. SEARCH STRATEGY: Relevant trials were identified in the register of trials maintained by the Cochrane Pregnancy and Childbirth Group. In addition, the Cochrane Controlled Trial Register, MEDLINE, and EMBASE were searched. Date of last search: October 2000. SELECTION CRITERIA: All randomised trials evaluating any antihypertensive drug treatment for mild to moderate hypertension during pregnancy, defined whenever possible as systolic blood pressure 140-169 mmHg and diastolic blood pressure 90-109 mmHg. Comparisons were of one or more antihypertensive drug(s) with placebo, with no antihypertensive drug, or with another antihypertensive drug, and where treatment was planned to continue for at least seven days. DATA COLLECTION AND ANALYSIS: Data were extracted independently by two reviewers. MAIN
resultsOverall, this review includes 40 studies (3797 women), 24 of which compared an antihypertensive drug with placebo/no antihypertensive drug (2815 women). There is a halving in the risk of developing severe hypertension associated with the use of antihypertensive drug(s) [17 trials, 2155 women; relative risk (RR) 0.52 (95% confidence interval (CI) 0.41 to 0.64); risk difference (RD) -0.09 (-0.12 to -0.06); number needed to treat (NNT) 12 (9 to 17)] but little evidence of a difference in the risk of pre-eclampsia [19 trials, 2402 women; RR 0.99 (0.84 to 1.18)]. Similarly, there is no clear effect on the risk of the baby dying [23 trials, 2727 women; RR 0.71(0.46 to 1.09)], preterm birth [12 trials, 1738 women; RR 0.98 (0.85 to 1.13)], or small for gestational age babies [17 trials, 2159 women; RR 1.13 (0.91 to 1.42)]. There were no clear differences in any other outcomes. Seventeen trials (1182 women) compared one antihypertensive drug with another. There is no clear difference between any of these drugs in the risk of developing severe hypertension, and proteinuria/pre-eclampsia. Other antihypertensive agents seem better than methyldopa for reducing the risk of the baby dying [14 trials, 1010 subjects, RR 0.49 (0.24 to 0.99); RD -0.02 (-0.04 to 0.00); NNT 45 (22 to 1341)]. Other outcomes were only reported by a small proportion of studies, and there were no clear differences. REVIEWER'S
conclusionsIt remains unclear whether antihypertensive drug therapy for mild-moderate hypertension during pregnancy is worthwhile.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.