Pregnant women taking antihypertensives—some shown to cause fetal risk—in increasing numbers

The prevalence of high blood pressure medications use in pregnancy is almost 5%, despite a lack of data on safety and proper use of these medications during pregnancy

Managing Editor

New research in the American Heart Association journal Hypertension indicates that almost 5% of pregnant women are prescribed antihypertensives, including some drugs that are contraindicated for mothers or their babies.

“Use of high blood pressure drugs during pregnancy is becoming increasingly common,” said Brian T. Bateman, MD, lead author and Assistant Professor of Anesthesia at Harvard Medical School in Boston, Massachusetts. "While we know high blood pressure, or hypertension, occurs in about 6% to 8% of all pregnancies, we know little about how women and their doctors treat the condition."¹

A database of more than 1 million Medicaid patients was studied. Of those patients, 48,453 (4.4%) filled prescriptions for high blood pressure drugs during their pregnancies.¹

Researchers found^1,2:

• Antihypertensive drug use increased from 3.5% to 4.9% between 2000 and 2006.

• Antihypertensive drug users were older than nonusers, more likely to have diabetes or kidney disease, and more likely to be white or black than Hispanic or Asian.

• Nearly 2% of pregnant women filled prescriptions for antihypertensive drugs during the first trimester; 1.7% during the second trimester; and 3.2% during the third trimester.

• Angiotensin-converting-enzyme (ACE) inhibitors and angiotensin receptor blockers—both of which have been shown to have harmful side effects during pregnancy—were used by 4.9% of users in the second trimester, and 1.1% in the third trimester.

Research is needed because there are limited data on the safety, efficacy, and proper use of antihypertensive drugs during pregnancy.

“These drugs can cause poor growth, kidney problems, and even death of the newborn, wrote Bateman. “If women are taking one of these blood pressure medications and they become pregnant or plan to do so, they and their doctors should discuss treatment choices during pregnancy.”¹

For access to the abstract, click here.

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