SynthesisBritish journal of clinical pharmacology2018
Drugs for treating severe hypertension in pregnancy: a network meta-analysis and trial sequential analysis of randomized clinical trials.
Synthesis in British journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 8 of them syntheses 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
37 citing papers in PubMed, 8 syntheses or guidelines pooled it, 107 citations in OpenAlex.
- Efficacy of pharmacological agents for management of post-partum hypertension: A systematic review and network meta-analysis.Journal of human hypertension · 2026Pooled it
- Executive Summary of the 2024 Philippine Clinical Practice Guidelines on the Diagnosis and Management of Acute Severe Blood Pressure Elevation.Journal of clinical hypertension (Greenwich, Conn.) · 2026Guideline
- Antihypertensive therapy for pregnancy hypertension and implications for fetal and neonatal heart rate monitoring: A systematic review of randomized trials and observational studies.Acta obstetricia et gynecologica Scandinavica · 2025Pooled it
- Intraclass comparison of inhaled corticosteroids for the risk of pneumonia in chronic obstructive pulmonary airway disorder: a network meta-analysis and meta-regression.International journal of clinical pharmacy · 2024Pooled it
- Pharmaceutical administration for severe hypertension during pregnancy: Network meta-analysis.Frontiers in pharmacology · 2022Pooled it
- Effect of bicyclol on blood biomarkers of NAFLD: a systematic review and meta-analysis.BMJ open · 2020Pooled it
- The Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials in Mozambique, Pakistan, and India: an individual participant-level meta-analysis.Lancet (London, England) · 2020Pooled it
- Drugs for treating severe hypertension in pregnancy: a network meta-analysis and trial sequential analysis of randomized clinical trials.British journal of clinical pharmacology · 2018Pooled it
- Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial.Lancet (London, England) · 2019Trial
- Current Understanding on Hypertensive Disorders in Pregnancy.International journal of general medicine · 2026Review
- Efficacy and safety of labetalol vs. Hydralazine in pregnant women with severe hypertension.Pakistan journal of medical sciences · 2026Article
- Polyphenolic Compounds in the Prevention and Treatment of Hypertension: A Review.International journal of molecular sciences · 2025Review
- Kaempferol modulates Wnt/ β-catenin pathway to alleviate preeclampsia- induced changes and protect renal and ovarian histomorphology.Journal of molecular histology · 2024Article
- Pharmacotherapeutic options for the treatment of hypertension in pregnancy.Expert opinion on pharmacotherapy · 2024Review
- Long-acting nifedipine in the management of essential hypertension: a review for cardiologists.American journal of cardiovascular disease · 2024Review
- Targeting mitochondrial shape: at the heart of cardioprotection.Basic research in cardiology · 2023Article
- Beta-Blockers and Their Current Role in Maternal and Neonatal Health: A Narrative Review of the Literature.Cureus · 2023Review
- Hypertension in Pregnancy: A Diagnostic and Therapeutic Overview.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2023Review
- Comparing Intravenous Labetalol and Intravenous Hydralazine for Managing Severe Gestational Hypertension.Cureus · 2023Article
- Comparison of efficacy of intravenous labetalol and intravenous hydralazine for management of pre-eclampsia in pregnant women.African health sciences · 2023Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsSeveral antihypertensive drugs are used in the treatment of severe hypertension in pregnancy. The present study is a network meta-analysis comparing the efficacy and safety of these drugs.
methodsElectronic databases were searched for randomized clinical trials comparing drugs used in the treatment of severe hypertension in pregnancy. The number of women achieving the target blood pressure (BP) was the primary outcome. Doses required and time taken for achieving the target BP, failure rate, and incidences of maternal tachycardia, palpitation, hypotension, headache, and neonatal death and stillbirth were the secondary outcomes. Mixed treatment comparison pooled estimates were generated using a random-effects model. Odds ratios for the categorical and mean difference for the numerical outcomes were the effect estimates.
resultsFifty-one studies were included in the systematic review and 46 in the meta-analysis. No significant differences in the number of patients achieving target BP was observed between any of the drugs. Diazoxide [-15 (-20.6, -9.4)], nicardipine [-11.8 (-22.3, -1.2)], nifedipine/celastrol [-19.3 (-27.4, -11.1)], nifedipine/vitamin D [-17.1 (-25.7, -9.7)], nifedipine/resveratrol [-13.9 (-22.6, -5.2)] and glyceryl trinitrate [-33.8 (-36.7, -31)] were observed to achieve the target BP (in minutes) more rapidly than hydralazine. Nifedipine required fewer doses than hydralazine for achieving the target BP. Glyceryl trinitrate and labetalol were associated with fewer incidences of tachycardia and palpitation respectively than hydralazine. Trial sequential analysis concluded adequate evidence for hydralazine and nifedipine compared with labetalol. Moderate quality of evidence was observed for direct comparison estimate between labetalol and hydralazine but was either low or very low for other comparisons.
conclusionThe present evidence suggests similar efficacy between nifedipine, hydralazine and labetalol in the treatment of severe hypertension in pregnancy. Subtle differences may exist in their safety profile. The evidence is inadequate for other drugs.
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