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antihypertensive and pregnancy

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https://www.readbyqxmd.com/read/29896480/use-of-antihypertensive-drugs-during-preeclampsia
#1
Obinnaya Odigboegwu, Lu J Pan, Piyali Chatterjee
Treatment of pregnancy-related hypertensive disorders, such as preeclampsia (PE), remain a challenging problem in obstetrics. Typically, aggressive antihypertensive drug treatment options are avoided to prevent pharmacological-induced hypotension. Another major concern of administering antihypertensive drugs during pregnancy is possible adverse fetal outcome. In addition, management of hypertension during pregnancy in chronic hypertensive patients or in patients with prior kidney problems are carefully considered...
2018: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29858105/cardiovascular-risk-profile-at-the-age-of-40-45-in-women-with-previous-hyperemesis-gravidarum-or-hypertensive-disorders-in-pregnancy-a-population-based-study
#2
Stine Fossum, Sigrun Halvorsen, Åse V Vikanes, Tessa J Roseboom, Inger Ariansen, Øyvind Næss
OBJECTIVE: To assess midlife cardiovascular risk profiles in women with a history of hyperemesis or hypertensive disorders in pregnancy compared to women with none of the studied pregnancy complications. STUDY DESIGN: Population-based study. Cardiovascular risk factors at the age of 40-45 among women with previous singleton births only were studied through linkage of the Norwegian Birth Registry and a Norwegian screening program (the Age 40 Program). MAIN OUTCOME MEASURES: Family history of coronary heart disease, body mass index, smoking, physical activity, systolic and diastolic blood pressure, heart rate, cholesterol, triglycerides, antihypertensive treatment and diabetes...
April 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29843629/antidepressant-use-during-pregnancy-and-the-risk-of-developing-gestational-hypertension-a-retrospective-cohort-study
#3
Neily Zakiyah, Loes F Ter Heijne, Jens H Bos, Eelko Hak, Maarten J Postma, Catharina C M Schuiling-Veninga
BACKGROUND: Prior studies reported that exposure to antidepressants during pregnancy may be associated with gestational hypertension. The aim of this study is to assess the association between the use of antidepressants during pregnancy and the risk of developing gestational hypertension. METHODS: A retrospective cohort study using the prescription database IADB.nl was conducted among nulliparous women with singleton pregnancies between 1994 and 2015 in the Netherlands...
May 29, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29766570/melatonin-improves-endothelial-function-in-vitro-and-prolongs-pregnancy-in-women-with-early-onset-preeclampsia
#4
Sebastian R Hobson, Seshi Gurusinghe, Rebecca Lim, Nicole O Alers, Suzanne L Miller, John C Kingdom, Euan M Wallace
Preeclampsia remains a leading cause of maternal and perinatal morbidity and mortality. There have been no material advances in the treatment of preeclampsia for nearly 50 years. Combining in vitro studies and a clinical trial, we aimed to determine if melatonin could be a useful adjuvant therapy. In a xanthine/xanthine oxidase (X/XO) placental explant model, melatonin reduced oxidative stress (8-isoprostane) and enhanced antioxidant markers (Nrf2 translocation, HO-1), but did not affect explant production of anti-angiogenic factors (sFlt, sEng, activin A)...
May 16, 2018: Journal of Pineal Research
https://www.readbyqxmd.com/read/29731014/hypertension-canada-s-2018-guidelines-for-the-management-of-hypertension-in-pregnancy
#5
Sonia Butalia, Francois Audibert, Anne-Marie Côté, Tabassum Firoz, Alexander G Logan, Laura A Magee, William Mundle, Evelyne Rey, Doreen M Rabi, Stella S Daskalopoulou, Kara A Nerenberg
We present Hypertension Canada's inaugural evidence-based Canadian recommendations for the management of hypertension in pregnancy. Hypertension in pregnancy is common, affecting approximately 7% of pregnancies in Canada, and requires effective management to reduce maternal, fetal, and newborn complications. Because of this importance, these guidelines were developed in partnership with the Society of Obstetricians and Gynaecologists of Canada with the main common objective of improving the management of women with hypertension in pregnancy...
May 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29686009/influence-of-gestational-age-at-initiation-of-antihypertensive-therapy-secondary-analysis-of-chips-trial-data-control-of-hypertension-in-pregnancy-study
#6
Anouk Pels, Ben Willem J Mol, Joel Singer, Terry Lee, Peter von Dadelszen, Wessel Ganzevoort, Elizabeth Asztalos, Laura A Magee
For hypertensive women in CHIPS (Control of Hypertension in Pregnancy Study), we assessed whether the maternal benefits of tight control could be achieved, while minimizing any potentially negative effect on fetal growth, by delaying initiation of antihypertensive therapy until later in pregnancy. For the 981 women with nonsevere, chronic or gestational hypertension randomized to less-tight (target diastolic blood pressure, 100 mm Hg), or tight (target, 85 mm Hg) control, we used mixed-effects logistic regression to examine whether the effect of less-tight (versus tight) control on major outcomes was dependent on gestational age at randomization, adjusting for baseline factors as in the primary analysis and including an interaction term between gestational age at randomization and treatment allocation...
June 2018: Hypertension
https://www.readbyqxmd.com/read/29663318/maternal-deaths-from-hypertensive-disorders-lessons-learnt
#7
Lill T Nyfløt, Liv Ellingsen, Branka M Yli, Pål Øian, Siri Vangen
INTRODUCTION: Hypertensive disorders of pregnancy have been the most frequent cause of maternal death in Norway since 1996 and are strongly associated with substandard care. In the UK, the number of maternal deaths due to hypertensive disorders has decreased drastically due to the implementation of updated guidelines, indicating a potential for reducing the number of deaths in other countries as well. Through audits of maternal deaths, we aim to prevent future deaths from hypertensive disorders in pregnancy by identifying suboptimal factors in treatment...
April 17, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29541029/pharmacogenomics-of-hypertension-and-preeclampsia-focus-on-gene-gene-interactions
#8
Marcelo R Luizon, Daniela A Pereira, Valeria C Sandrim
Hypertension is a leading cause of cardiovascular mortality, but only about half of patients on antihypertensive therapy achieve blood pressure control. Preeclampsia is defined as pregnancy-induced hypertension and proteinuria, and is associated with increased maternal and perinatal mortality and morbidity. Similarly, a large number of patients with preeclampsia are non-responsive to antihypertensive therapy. Pharmacogenomics may help to guide the personalized treatment for non-responsive hypertensive patients...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29528138/when-is-more-frequent-hemodialysis-beneficial
#9
Rita S Suri, Alan S Kliger
The use of frequent hemodialysis (HD) is growing, with the hope of improving outcomes in end-stage renal disease. We narratively review the three randomized trials, 15 comparative cohort studies, and several case series of frequent HD that empirically demonstrate the potential efficacy and adverse effects of these regimens. Taken together, the randomized studies suggest frequent HD may result in left ventricular mass regression. This effect is most pronounced when left ventricular mass is abnormal, but attenuated by significant residual urine output...
March 12, 2018: Seminars in Dialysis
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
#10
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)...
April 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
#11
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
#12
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
#13
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
#14
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
#15
Diane Nzelu, Dan Dumitrascu-Biris, Kypros H Nicolaides, Nikos A Kametas
BACKGROUND: There is extensive evidence that prepregnancy chronic hypertension is associated with a high risk of development of severe hypertension and preeclampsia and birth of small-for-gestational-age neonates. However, previous studies have not reported whether antihypertensive use, blood pressure control, or normalization of blood pressure during early pregnancy influences the rates of these pregnancy complications. OBJECTIVE: The purpose of this study was to stratify women with prepregnancy 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 to examine the rates of severe hypertension, preeclampsia, and birth of small-for-gestational-age neonates according to such stratification...
March 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29187414/postpartum-management-of-hypertensive-disorders-of-pregnancy-a-systematic-review
#16
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
#17
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
#18
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
#19
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
#20
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
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