Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy.
A Working Group on Research in Hypertension in Pregnancy was recently convened by the National Heart, Lung, and Blood Institute to determine the state of knowledge in this area and suggest appropriate directions for research. Hypertensive disorders in pregnancy, especially preeclampsia, are a leading cause of maternal death worldwide and even in developed countries increase perinatal mortality rates 5-fold. Much has been learned about preeclampsia, but gaps in the knowledge necessary to direct therapeutic strategies remain. Oxidative stress is a biologically plausible contributor to the disorder that may be amenable to intervention. Hypertension that antedates pregnancy (chronic hypertension) bears many similarities to hypertension in nonpregnant women, but the special setting of pregnancy demands information to guide evidence-based therapy. The recommendations of the Working Group are to attempt a clinical trial of antioxidant therapy to prevent preeclampsia that is be complemented by mechanistic research to increase understanding of the genetics and pathogenesis of the disorder. For chronic hypertension, clinical trials are recommended to direct choice of drugs, evaluate degree of control, and assess implications to the mother and fetus. Recommendations to increase participation in this research are also presented.
Roberts
James M
JM
Department of Obstetrics, Gynecology and Reproductive Sciences, Graduate School of Public Health, University of Pittsburgh, and Magee-Womens Research Institute, Pittsburgh, Pa, USA. rsijmr@mail.magee.edu
Pearson
Gail
G
Cutler
Jeff
J
Lindheimer
Marshall
M
D000975:Antioxidants / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006973:Hypertension / Q000145:classification / Q000188:drug therapy; D008431:Maternal-Fetal Exchange; D009316:National Institutes of Health (U.S.); D018384:Oxidative Stress; D011225:Pre-Eclampsia / Q000150:complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000145:classification / Q000188:drug therapy; D012106:Research; D012307:Risk Factors; D014481:United States
D000975:Antioxidants