Key result
Calcium channel blockers reduced persistent high blood pressure compared to hydralazine in pregnant women with severe hypertension (8% vs 22%; RR 0.37, 95% CI 0.21-0.66).
Why the study?
Do specific antihypertensive drugs improve blood pressure control and safety compared to others in women with severe hypertension during pregnancy?
Population
3573 women with severe hypertension during pregnancy across 35 randomized trials
Comparison
Antihypertensive drugs vs Other antihypertensive drugs
Design
Meta-analysis
Authors
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Calcium channel blockers should be preferred over hydralazine for severe hypertension in pregnancy; confirms superiority in RCT meta-analysis.
Systematic Review (n=3,573)
Do specific antihypertensive drugs improve blood pressure control and safety compared to others in women with severe hypertension during pregnancy?
Effect estimate: RR 0.37 (95% CI 0.21 to 0.66)
Absolute Event Rate: 8% vs 22%
Calcium channel blockers appear more effective than hydralazine for controlling severe hypertension in pregnancy, while drugs like diazoxide, ketanserin, and nimodipine are probably best avoided.
Duley et al. (2013) conducted a systematic review in Severe hypertension during pregnancy (n=3,573). Calcium channel blockers vs. Hydralazine was evaluated on Persistent high blood pressure (RR 0.37, 95% CI 0.21 to 0.66). Calcium channel blockers reduced persistent high blood pressure compared to hydralazine in pregnant women with severe hypertension (8% vs 22%; RR 0.37, 95% CI 0.21-0.66).
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