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 mortality worldwide and even in developed countries increase perinatal mortality five-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, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. rsijmr@mail.magee.edu
Pearson
Gail D
GD
Cutler
Jeffrey A
JA
Lindheimer
Marshall D
MD
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000145:classification* / Q000188:drug therapy*; D008431:Maternal-Fetal Exchange; D018384:Oxidative Stress / Q000502:physiology; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000145:classification* / Q000188:drug therapy*; D012106:Research; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D014481:United States
D000959:Antihypertensive Agents; D000975:Antioxidants