Farmacie pro praxi. 2023;19(3):e10-e14 [Klin Farmakol Farm. 2023;37(2):59-63]

Drug treatment of hypertension in pregnancy

Renata Cífková^{1, 2}

¹ Centrum kardiovaskulární prevence 1. lékařské fakulty Univerzity Karlovy a Fakultní Thomayerovy nemocnice, Praha

² II. interní klinika 1. lékařské fakulty Univerzity Karlovy a Všeobecné fakultní nemocnice, Praha

Hypertension is the most frequent non-obstetric complication effecting about 10% of pregnancies. Hypertension in pregnancy is classified as either pre-existing (chronic) or gestational, developing after 20 weeks of gestation and usually resolving within 6 weeks postpartum. Systolic blood pressure ≥ 170 mmHg or diastolic blood pressure ≥ 110 mmHg are considered an emergency and hospitalization is indicated. The selection of antihypertensive drugs and the way they are administered depend on blood pressure values, gestational age and the estimated time of delivery. According to the current European and Czech guidelines, initiation of drug treatment is recommended at values > 140/90 mmHg in women with gestational hypertension (with or without proteinuria), with pre-existing hypertension with the superimposition of gestational hypertension and with hypertension complicated by hypertension mediated organ damage or symptoms at any time during pregnancy. In all other cases, drug treatment may be postponed until blood pressure reaches 150/95 mmHg. Methyldopa, labetalol, and calcium antagonists (nifedipine in particular) are the drugs of choice. Hypertensive disorders of pregnancy are associated with a higher risk of developing hypertension later in life as well as cardiovascular disease.

Keywords: classification of hypertension in pregnancy, threshold for initiating drug treatment of hypertension in pregnancy, methyldopa, labetalol, calcium antagonists, hypertension in pregnancy and subsequent cardiovascular risk.

Published: October 2, 2023  Show citation