Randomised comparison of methyldopa and oxprenolol for treatment of hypertension in pregnancy.

Gallery, Eileen D.M.; Dm, Saunders; Hunyor, Stephen N.; Györy, Á. Z.

doi:10.1136/bmj.1.6178.1591

Cited by 149 publications

(35 citation statements)

References 21 publications

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“…Thus the present group might be considered unsuitable for the assessment of efficacy of atenolol. There is no theoretical reason why atenolol should not be a suitable antihypertensive agent for pregnant patients, as has been the case for other ,8-adrenoceptor blockers such as oxprenolol (Gallery et al, 1979), propranolol (Eliahou et al, 1978), labetolol (Lamming & Symonds, 1979) and metoprolol (Sandstrom, 1978).…”

Section: Results (I) Pharmacokinetic Studymentioning

confidence: 99%

Atenolol in the treatment of pregnancy‐induced hypertension.

Thorley¹,

McAinsh²,

Cruickshank³

1981

Brit J Clinical Pharma

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1 The pharmacological properties of atenolol suggest its possible usefulness in pregnancy‐induced hypertension. The pharmacokinetics of atenolol in the pregnant woman, concentrations in cord blood, and its effects on maternal blood pressure and the foetus, are evaluated. 2 We studied 13 pregnant women with hypertension, most of them uncontrolled on methyldopa. Whole blood concentrations and urinary excretion of the drug were measured over 24 h following a 100 mg dose. Effects on maternal blood pressure, pulse rate and foetal heart rate and cardiotocograph were compared for the 4 days before treatment and the first 4 days of treatment. The birth weights and Apgar scores of the babies were recorded. 2 The pharmacokinetics of atenolol (plasma half‐ life of about 8 h) in pregnant women do not differ from the findings in the non‐pregnant. The levels of atenolol in the cord blood were confirmed as approximately equal to those in the maternal blood. 4 In the ten women in whom blood pressure was assessed a small significant fall in blood pressure was observed. 5 A 5% mean fall in foetal heart rate resulted but in one case was a rate below 120 beats/min recorded. There was no evidence of depression of the stress response of the foetal heart. Apgar scores 5 min post partum were satisfactory. 6 Atenolol appears to be safe for use in hypertensive pregnancies. Its effectiveness as an antihypertensive agent in pregnancy requires further controlled evaluation.

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Section: Results (I) Pharmacokinetic Studymentioning

confidence: 99%

Atenolol in the treatment of pregnancy‐induced hypertension.

Thorley¹,

McAinsh²,

Cruickshank³

1981

Brit J Clinical Pharma

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“…One of the studies found it necessary to add hydralazine to both treatment regimens of oxprenalol and methyldopa for improved blood pressure control. 16 Combination drug therapy confuses an already complex condition involving the mother and the foetus. The reported effects of antihypertensive drugs on the placental circulation and therefore oxygenation of the foetus are conflicting.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of antihypertensive drugs in the management of pregnancy-induced hypertension

Patel

Gadhavi

Gorasia

et al. 2012

Int J Basic Clin Pharmacol

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Background: Pregnancy-induced hypertension is associated with various adverse fetal and maternal outcomes. The use of anti-hypertensive drugs in pregnancy is controversial. We conducted a prospective study to evaluate the comparative effectiveness and safety of nifedipine, methyldopa and labetalol monotherapy in patients with pregnancy-induced hypertension. Methods: A total of 60 pregnant women with blood pressure of 140/90 mm Hg or more with ≥1+ proteinuria between 20 and 38 weeks of gestation were randomly allocated to receive nifedipine (n=20), methyldopa (n=20) or labetalol (n=20). Blood pressure was measured at 0, 6, 24, 48 and 72 h of initiation of antihypertensive drugs. Patients were also followed up for development of adverse drug effects during this period. Results: Antihypertensive treatment with methyldopa was associated with reduction in systolic blood pressure (SBP) by 50 mmHg and diastolic blood pressure (DBP) by 30 mmHg at 72 h. For the same period treatment with nifedipine was associated with reduction in SBP by 54 mmHg and DBP by 30 mmHg. Treatment with labetalol was associated with reduction in SBP by 70 mmHg and DBP by 36 mmHg at 72 h. Conclusions: Labetalol was more effective than methyldopa and nifedipine in controlling blood pressure in patients with pregnancy-induced hypertension while methyldopa and nifedipine are equally effective in controlling blood pressure. [Int J Basic Clin Pharmacol 2012; 1(3.000): 174-177

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“…There is still confusion amongst clinicians concerning treatment and consequently the disease accounts for significant maternal and foetal mortality and morbidity. Despite the confusion recent reports show that control of hypertension in pregnancy by antihypertensive drugs results in better survival (Michael 1975;Redman et al, 1976;Michael, 1979a;Gallery et al, 1979).…”

Section: Introductionmentioning

confidence: 99%

The evaluation of labetalol in the treatment of hypertension complicating pregnancy.

Ca¹

1982

Brit J Clinical Pharma

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1 Eighty‐five women with severe hypertension complicating pregnancy were treated with oral labetalol (Trandate). Six of these had a twin pregnancy and 54 had proteinuria. 2 Effective control of the blood pressure was achieved in all but six patients. The maximum dose of labetalol prescribed was 1200 mg daily. There were no significant maternal or foetal side‐effects. 3 Foeto‐placental function was carefully monitored in all patients. Twenty‐four of the 89 infants born alive showed evidence of intra‐uterine growth retardation, the highest incidence occurring in the group of patients with essential hypertension complicated by pregnancy induced hypertension. 4 The low perinatal mortality of 4.4% was a reflection of the meticulous control of the blood pressure. 5 There were no congenital malformations or evidence of oculotoxicity in any of the infants delivered. 6 The efficient hypotensive action of orally administered labetalol together with the absence of maternal and foetal side effects and consequent improved perinatal mortality confirms that it is an eminently suitable drug for the treatment of hypertension complicating pregnancy.

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Randomised comparison of methyldopa and oxprenolol for treatment of hypertension in pregnancy.

Cited by 149 publications

References 21 publications

Atenolol in the treatment of pregnancy‐induced hypertension.

Atenolol in the treatment of pregnancy‐induced hypertension.

Comparative evaluation of antihypertensive drugs in the management of pregnancy-induced hypertension

The evaluation of labetalol in the treatment of hypertension complicating pregnancy.

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