Pathophysiology and medical management of systemic hypertension and pre-eclampsia in pregnancy.
Hypertension in pregnancy includes a group of distinct disorders that require special consideration in both prevention and pharmacological treatment. In recent years, there have been few advances regarding the pathophysiology and prevention of pre-eclampsia, however there have been some promising studies regarding possible modes of screening women for preeclampsia before clinical signs and symptoms are apparent. The recommendations for first-line drug therapy for the hypertensive complications of pre-eclampsia, and the recommendations for pharmacological treatment of women with chronic hypertension antedating pregnancy, have changed little primarily because first-line medications have the advantage of having had more extensive research experience. Recent clinical trials have demonstrated the efficacy and safety of various second-line drugs for the hypertensive disorders of pregnancy; whether these therapies can eventually replace the standard recommended medications will require more extensive long-term investigation.
Frishman
W H
WH
Department of Medicine, New York Medical College, Westchester Medical Center, Valhalla, NY 10595, USA. Joanne-pryor@nymc.edu
Veresh
M
M
Schlocker
S J
SJ
Tejani
N
N
D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D001795:Blood Pressure Determination; D002136:Calcium, Dietary / Q000008:administration & dosage; D002908:Chronic Disease; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D011225:Pre-Eclampsia / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology* / Q000517:prevention & control; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology*; D016032:Randomized Controlled Trials as Topic; D012084:Renin-Angiotensin System / Q000502:physiology; D012146:Rest; D012307:Risk Factors
D000959:Antihypertensive Agents; D002136:Calcium, Dietary; D004232:Diuretics; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin