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antihypertensive and pregnancy

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https://www.readbyqxmd.com/read/29448118/calcium-channel-blockers-as-drug-repurposing-candidates-for-gestational-diabetes-mining-large-scale-genomic-and-electronic-health-records-data-to-repurpose-medications
#1
Jeffery A Goldstein, Lisa A Bastarache, Joshua C Denny, Dan M Roden, Jill M Pulley, David M Aronoff
New therapeutic approaches are needed for gestational diabetes mellitus (GDM), but must show safety and efficacy in a historically understudied population. We studied associations between electronic medical record (EMR) phenotypes and genetic variants to uncover drugs currently considered safe in pregnancy that could treat or prevent GDM. We identified 129 systemically active drugs considered safe in pregnancy targeting the proteins produced from 196 genes. We tested for associations between GDM and/or type 2 diabetes (DM2) and 306 SNPs in 130 genes represented on the Illumina Infinium Human Exome Bead Chip (DM2 was included due to shared pathophysiological features with GDM)...
February 12, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29411149/pharmacological-treatment-of-attention-deficit-hyperactivity-disorder-during-pregnancy-and-lactation
#2
REVIEW
Asher Ornoy
INTRODUCTION: Attention deficit/hyperactivity disorder (ADHD) is a neurobehavioral problem found in 2-5% of adults. Stimulants and drugs that affect the dopaminergic, noradrenergic and/or serotonergic systems are effective treatment and are increasingly prescribed to women at child bearing age. It is consequently important that reliable information on the safety of these drugs in pregnancy is available so that appropriate therapeutic choices can be made. RESULTS: The data on stimulants (methylphenidate and amphetamines) are generally showing that there is no increase in the rate of major congenital anomalies...
February 6, 2018: Pharmaceutical Research
https://www.readbyqxmd.com/read/29380922/longitudinal-changes-in-vascular-function-parameters-in-pregnant-women-with-chronic-hypertension-and-association-with-adverse-outcome-a-cohort-study
#3
Louise M Webster, Jenny E Myers, Catherine Nelson-Piercy, Charlotte Mills, Ingrid Watt-Coote, Asma Khalil, Paul T Seed, J Kennedy Cruickshank, Lucy C Chappell
OBJECTIVES: Raised vascular function measures are associated with development of adverse maternal and perinatal outcomes in low risk pregnancy. This study aimed to evaluate the association between longitudinal vascular function parameters and adverse outcomes in pregnant women with chronic hypertension. METHODS: Pregnant women recruited to the PANDA (Pregnancy And chronic hypertension: NifeDipine vs lAbetalol as antihypertensive treatment) trial in three UK maternity units had serial pulse wave analyses performed using the Arteriograph® (Tensiomed, Budapest, Hungary) while in a sitting position from 12 weeks onwards...
January 30, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29346423/the-association-of-estimated-salt-intake-with-blood-pressure-in-a-viet-nam-national-survey
#4
Paul N Jensen, Tran Quoc Bao, Tran Thi Thanh Huong, Susan R Heckbert, Annette L Fitzpatrick, James P LoGerfo, Truong Le Van Ngoc, Ali H Mokdad
OBJECTIVE: To evaluate the association of salt consumption with blood pressure in Viet Nam, a developing country with a high level of salt consumption. DESIGN AND SETTING: Analysis of a nationally representative sample of Vietnamese adults 25-65 years of age who were surveyed using the World Health Organization STEPwise approach to Surveillance protocol. Participants who reported acute illness, pregnancy, or current use of antihypertensive medications were excluded...
2018: PloS One
https://www.readbyqxmd.com/read/29338776/takayasu-arteritis-a-cause-of-hypertensive-disorder-of-pregnancy-a-case-report
#5
Jesus Lumbreras-Marquez, Roberto Arturo Castillo-Reyther, Salvador De-la-Maza-Labastida, Fernando Vazquez-Alaniz
BACKGROUND: Takayasu arteritis is a rare, chronic, granulomatous systemic vasculitis of unknown etiology and a few cases have been reported in pregnancy. In pregnancies concomitant with Takayasu arteritis or after diagnosis, Takayasu arteritis negatively affects pregnancy by increasing 13-fold the odds of complications such as hypertensive disorders. The best recommendations in this scenario are still to be made. CASE PRESENTATION: We present a case of 21-year-old, gravid 1, Mexican woman of Mestizo descent with chronic hypertension diagnosed since she was 15-years old who presented severe hypertension during pregnancy (early second trimester); the diagnosis of hypertensive disorder of pregnancy was ruled out requiring first-line and second-line antihypertensive therapy without serious associated maternal or fetal morbidity...
January 17, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29305253/chronic-hypertension-first-trimester-blood-pressure-control-and-likelihood-of-severe-hypertension-preeclampsia-and-small-for-gestational-age
#6
Diane Nzelu, Dan Dumitrascu-Biris, Kypros H Nicolaides, Nikos A Kametas
BACKGROUND: There is extensive evidence that pre-pregnancy chronic hypertension is associated with high risk of development of severe hypertension and preeclampsia and birth of small for gestational age neonates. However, previous studies have not reported whether anti-hypertensive use, blood pressure control or normalization of blood pressure during early pregnancy influence the rates of these pregnancy complications. OBJECTIVE: To stratify women with pre-pregnancy chronic hypertension according to the use of antihypertensive medications and level of blood pressure control at the first hospital visit during the first-trimester of pregnancy and examine the rates of severe hypertension, preeclampsia and birth of small for gestational age neonates according to such stratification...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29187414/postpartum-management-of-hypertensive-disorders-of-pregnancy-a-systematic-review
#7
Alexandra E Cairns, Louise Pealing, James M N Duffy, Nia Roberts, Katherine L Tucker, Paul Leeson, Lucy H MacKillop, Richard J McManus
OBJECTIVES: Hypertensive disorders of pregnancy (HDP) affect one in ten pregnancies and often persist postpartum when complications can occur. We aimed to determine the effectiveness and safety of pharmacological interventions, other interventions and different care models for postpartum hypertension management. DESIGN: A systematic review was undertaken. Nine electronic databases, including Medline, were searched from inception to 16 March 2017. After duplicate removal, 4561 records were screened...
November 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29181841/epidural-therapy-for-the-treatment-of-severe-pre-eclampsia-in-non-labouring-women
#8
REVIEW
Amita Ray, Sujoy Ray
BACKGROUND: Pre-eclampsia is a pregnancy-specific multi-organ disorder, which is characterised by hypertension and multisystem organ involvement and which has significant maternal and fetal morbidity and mortality. Failure of the placental vascular remodelling and reduced uteroplacental flow form the etiopathological basis of pre-eclampsia. There are several established therapies for pre-eclampsia including antihypertensives and anticonvulsants. Most of these therapies aim at controlling the blood pressure or preventing complications of elevated blood pressure, or both...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29153666/prevalence-risk-factors-and-associated-complications-of-postpartum-hypertension-in-rural-haiti
#9
Eleanor Kang, Rebekah Sugarman, Hadi Ramadan, Ariel Mueller, Sana Shahul, Joana Lopes Perdigao, David Jean Louis, Rulx Narcisse, Herriot Sannon, Laura Magee, Sarosh Rana
BACKGROUND: The prevalence of hypertensive disorders during pregnancy is high in developing countries such as Haiti, however little is known about postpartum hypertension (PPHTN). METHODS: This is a prospective study done at Hospital Albert Schweitzer in rural Haiti among pregnant women age 18 or older who were admitted for labor. Blood pressures were collected before and after delivery and medical charts were reviewed to gather delivery characteristics and fetal/neonatal outcomes...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29153663/prognostic-model-for-chronic-hypertension-in-women-with-a-history-of-hypertensive-pregnancy-disorders-at-term
#10
V S Visser, W Hermes, J Twisk, A Franx, M G van Pampus, C Koopmans, B W J Mol, C J M de Groot
INTRODUCTION: The association between hypertensive pregnancy disorders and cardiovascular disease later in life is well described. In this study we aim to develop a prognostic model from patients characteristics known before, early in, during and after pregnancy to identify women at increased risk of cardiovascular disease e.g. chronic hypertension years after pregnancy complicated by hypertension at term. METHODS: We included women with a history of singleton pregnancy complicated by hypertension at term...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29143739/an-inaccurate-automated-device-negatively-impacts-the-diagnosis-and-treatment-of-gestational-hypertension
#11
Diane Nzelu, Felicia Yeung, Delphine Couderq, Andrew Shennan, Nikos A Kametas
OBJECTIVES: Automated blood pressure devices are frequently introduced in maternity care without prior validation for their accuracy in pregnancy. Our objectives were to, firstly, establish the accuracy in pregnancy of a locally used device (Welch Allyn 300) and, secondly, to audit its impact on the diagnosis and treatment of hypertension. STUDY DESIGN: Validation study: The device was evaluated using the grading criteria of the European Society of Hypertension International Protocol (ESH-IP) (2010)...
May 3, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29133363/prevalence-of-hypertensive-phenotypes-after-preeclampsia-a-prospective-cohort-study
#12
Agnès Ditisheim, Grégoire Wuerzner, Belen Ponte, Yvan Vial, Olivier Irion, Michel Burnier, Michel Boulvain, Antoinette Pechère-Bertschi
Preeclampsia is associated with increased cardiovascular and renal risk. The aim of this prospective cohort study was to characterize the early postpartum blood pressure (BP) profile after preeclampsia. We enrolled 115 women with preeclampsia and 41 women with a normal pregnancy in a prospective cohort study. At 6 to 12 week postpartum, we assessed the prevalence of different hypertensive phenotypes using 24-hour ambulatory BP monitoring (ABPM), as well as the risk of salt sensitivity and the variability of BP derived from ABPM parameters...
January 2018: Hypertension
https://www.readbyqxmd.com/read/29124624/maternal-hypertension-antihypertensive-medication-use-and-small-for-gestational-age-births-in-the-national-birth-defects-prevention-study-1997-2011
#13
Sarah C Fisher, Alissa R Van Zutphen, Paul A Romitti, Marilyn L Browne
Background Small for gestational age (SGA) birth is associated with poor long-term health outcomes. It is unclear whether maternal antihypertensive medication increases risk of SGA independently of maternal hypertension. Methods We analyzed associations between maternal hypertension and antihypertensive medication use and SGA among non-malformed singleton controls in the National Birth Defects Prevention Study. We defined SGA as birthweight < 10th percentile for a given gestational age, sex, race/ethnicity, and parity...
November 9, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29113921/antihypertensive-responses-of-vasoactive-androgens-in-an-in-vivo-experimental-model-of-preeclampsia
#14
Mercedes Perusquía, Andrea E Hanson, Claudia M Meza, Cris Kubli, Nieves Herrera, John N Stallone
Dehydroepiandrosterone (DHEA), testosterone (TES) and its 5-reduced metabolites induce a nongenomic vasorelaxation in several vascular beds of mammals; similarly these hormones produce systemic hypotensive and antihypertensive responses in normotensive and hypertensive male rats. Thus, it was hypothesized that the antihypertensive response of androgens, whose levels are elevated during gestation, protect against gestational hypertension. An animal model of preeclampsia was induced in female Wistar rats using DOCA-salt-treated pregnant (PT) and normal pregnant (NP) rats...
November 4, 2017: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/29109631/comparative-evaluation-of-midazolam-dexmedetomidine-and-propofol-as-intensive-care-unit-sedatives-in-postoperative-electively-ventilated-eclamptic-patients
#15
Malik Rameez Rashid, Rukhsana Najeeb, Saima Mushtaq, Rizwana Habib
Background and Aims: Eclampsia is a common hypertensive disorder of pregnancy and treatment often includes termination of pregnancy with elective postoperative mechanical ventilation. The present study was aimed to compare midazolam, propofol, and dexmedetomidine for sedation and antihypertensive requirements of such patients admitted to Intensive Care Unit (ICU) after termination of pregnancy. Material and Methods: A total of ninety eclamptic patients administered general anesthesia for the termination of pregnancy through cesarean section and who also required postoperative ventilation were taken up for the study and were randomly allocated into three groups...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28994336/chronic-hypertension-effect-of-blood-pressure-control-on-pregnancy-outcome
#16
Anca M Panaitescu, Stephanie Roberge, Kypros H Nicolaides
CONTEXT: In pregnancies with chronic hypertension (CH), compared to those without CH, there is a 10-fold increase in the risk of preeclampsia (PE) and two-fold increase in risk of small for gestational age (SGA) neonates. OBJECTIVE: To examine the evidence of whether in patients with CH and mild to moderate hypertension the level of control of blood pressure during pregnancy has a beneficial or adverse effect on the risk of PE or SGA. METHOD: We performed a systematic review and meta-analysis of randomized controlled trials of patients with mild to moderate CH in pregnancy that reported the impact of different levels of control of blood pressure on the risk of PE or SGA...
October 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28946858/comparative-analysis-of-package-inserts-of-local-and-imported-antihypertensive-medications-in-palestine
#17
Sandra A Qatmosh, Amer A Koni, Baraa G Qeeno, Dina A Arandy, Maysa W Abu-Hashia, Bahaa M Al-Hroub, Sa'ed H Zyoud
BACKGROUND: Package inserts (PIs) as a reliable reference for patients and health care providers should provide accurate, complete and up-to-date information. The purpose of the current study is to assess and compare the PIs of antihypertensive agents locally produced in Palestine and their imported counterparts. METHODS: Thirty-five PIs were assessed for the presence of 31 information statements using a scoring method. Word counting of 20 headings and subheadings was used to evaluate and compare local and imported PIs for information quantity...
September 25, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28919617/response-side-effects-of-injectable-labetalol-in-pregnancy-induced-severe-hypertension
#18
F A Akter, K Nahar, M M Rahman, R A Ferdousi, M U Ahmed, F Begum, D Biswas, M Alom, M Z Hossain, R Z Razi
The study was performed to assess the response & side effects of injectable Labetalol in the treatment of pregnancy induced severe hypertension. This interventional study was carried out on 72 patients having pregnancy induced severe hypertension attended in the Department of Obstetrics & Gynaecology, Mymensingh Medical College & Hospital (MMCH), Mymensingh, Bangladesh from November 2009 to October 2010. All patients were treated with intravenous Labetalol 20mg & the dose was repeated at sequential escalating dosages every 15 minutes until a therapeutic goal of systolic blood pressure <160mm of Hg & diastolic blood pressure <105mm of Hg were achieved...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28919605/current-trend-of-using-anti-hypertensives-in-pregnancy-and-postpartum-period-in-a-tertiary-level-hospital
#19
M Sultana, S K Saha, A K Sarker, S Khatun, M M Sarker, T Sultana, F Noor, M M Faysal
Hypertensive disorders are one of the most common disorders in pregnancy. They are amongst the major cause of maternal and perinatal morbidity and mortality. Incidence is increasing in developing countries like Bangladesh. This cross sectional descriptive study has done to observe the utilization of antihypertensive drugs in hypertensive disorders of pregnancy and conducted from January 2016 to December 2016 in the department of Pharmacology in collaboration with department of Gynecology and Obstetrics in Mymensingh Medical College Hospital, Mymensingh, Bangladesh...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28894975/reperfusion-of-the-choriocapillaris-observed-using-optical-coherence-tomography-angiography-in-hypertensive-choroidopathy
#20
Miwa Saito, Akihiro Ishibazawa, Reiko Kinouchi, Akitoshi Yoshida
PURPOSE: Optical coherence tomography angiography (OCTA) can visualize the vascular status of the choriocapillaris noninvasively and separately from the other vascular beds. We describe focal ischemia in the choriocapillaris and reperfusion of the area in hypertensive choroidopathy using en-face OCTA. CASE: A 32-year-old woman diagnosed with pregnancy-induced hypertension presented with acute anorthopia in the right eye after delivery via Caesarian section. Fundus examination showed an Elschnig's spot and serous retinal detachment (SRD) in the inferior perifoveal region...
September 11, 2017: International Ophthalmology
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