Key result
Oral nifedipine required a lower meantime and fewer doses to achieve target blood pressure compared to other antihypertensive medications in hypertensive disorders of pregnancy (P<0.05).
Why the study?
Hypertensive disorders of pregnancy are frequent conditions causing fetal and maternal morbidity and mortality, prompting a comparison of the efficacy and safety of nifedipine versus other antihypertensives.
Does oral nifedipine reduce the time and number of doses required to achieve target blood pressure in pregnant women with hypertensive disorders compared to other antihypertensive medications?
Meta-Analysis (n=2,595)
Does oral nifedipine reduce the time and number of doses required to achieve target blood pressure in pregnant women with hypertensive disorders compared to other antihypertensive medications?
p-value: p=<0.05
Oral nifedipine is more effective than other antihypertensive medications at rapidly reducing blood pressure in hypertensive disorders of pregnancy.
Supports oral nifedipine for faster BP control in hypertensive pregnancy disorders; confirms meta-analytic advantage over alternatives.
BACKGROUND: Hypertensive disorders of pregnancy are the most frequently occurring medical condition during pregnancy, resulting in fetal and/or maternal morbidity and mortality. This meta-analysis compared the efficacy and safety of nifedipine with other antihypertensive medications used in hypertensive disorders of pregnancy. METHODOLOGY: A comprehensive search was performed using PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar. The meta-analysis was carried out using Review Manager Software, and the pooled effect estimate was generated as standardized mean difference and odds ratio with 95% confidence interval and two-sided P -value. RESULTS: The meta-analysis was comprised of 22 randomized control trials with 2595 participants. It was found that meantime and number of doses required to achieve target blood pressure were lower in the nifedipine group ( P < 0.05). Even though it is statistically insignificant, fetal APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) scores less than seven favors nifedipine intervention. Furthermore, none of the fetal or maternal secondary outcomes were found significant. CONCLUSION: Nifedipine was found to be more effective than other antihypertensive medications to reduce blood pressure, particularly in patients with severe hypertension. However, future clinical studies, including real-world data are necessary to establish the safety profile of nifedipine concerning the fetal outcomes in hypertensive pregnant women.
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George et al. (2022) conducted a meta-analysis in Hypertensive disorders of pregnancy (n=2,595). Oral nifedipine vs. Other antihypertensive medications was evaluated on Meantime and number of doses required to achieve target blood pressure (p=<0.05). Oral nifedipine required a lower meantime and fewer doses to achieve target blood pressure compared to other antihypertensive medications in hypertensive disorders of pregnancy (P<0.05).
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