SynthesisBMJ open2024
Oral antihypertensive agents and diuretics in the management of hypertension in postpartum women: a systematic review and meta-analysis.
Synthesis in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 3 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
5 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Efficacy of pharmacological agents for management of post-partum hypertension: A systematic review and network meta-analysis.Journal of human hypertension · 2026Pooled it
- Effects of Immediate Postpartum Diuretic Treatment on Postpartum Blood Pressure Among Individuals With Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis.Hypertension (Dallas, Tex. : 1979) · 2026Pooled it
- Pooled it
- Persistent and de novo postpartum hypertension: a scoping review of pathophysiology, evaluation, and management.NPJ cardiovascular health · 2026Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn the puerperium, women with hypertensive disease of pregnancy remain at risk for maternal complications. The antihypertensive agent prescribed antepartum is usually continued postpartum; however, evidence regarding the most effective treatment is lacking. Therefore, we aimed to investigate which antihypertensive agent results in optimal treatment (both effectiveness and safety) of postpartum hypertension.
designSystematic review and meta-analysis. DATA SOURCES: MEDLINE (Ovid), Embase.com and CENTRAL were searched through 22 August 2024. ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) evaluating oral antihypertensives and diuretics in postpartum hypertensive women published after 1990, performing BP measurements in the postpartum period, were identified. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data and assessed risk of bias. Pooled data were calculated as risk ratio or mean difference using a random effect model.
resultsFourteen RCTs (1651 women) were included. Seven RCTs compared diuretics with placebo or antihypertensive controlled, two RCTs compared oral antihypertensives with placebo and five RCTs compared labetalol with nifedipine. Pooled data demonstrated a significantly lower BP on day 3 in cases with pre-eclampsia using furosemide (mean difference -4.06, 95% CI -6.81 to -1.31). Furosemide had no significant effect on any of the other outcomes. Faster BP control was observed for labetalol over nifedipine in a single RCT (mean difference 5.20, 95% CI 4.36 to 6.04). No other significant effects were observed.
conclusionsIn this extensive literature review, no medication preference could be stated and a lack of high-quality studies was revealed. Some evidence demonstrates a positive effect on BP control in women with pre-eclampsia using furosemide. Therefore, adding furosemide to initial treatment is considerable. However, antihypertensive preference and furosemide effectiveness should be further researched. We propose a retrospective cohort study using real-life hospital data (from health records), utilising clinical variance in therapeutic strategies currently present. PROSPERO REGISTRATION NUMBER: CRD42023410765.
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