[Pharmacological treatment of non-severe hypertension during pregnancy, postpartum and breastfeeding].

Autor: Ghelfi AM; Servicio de Clínica Médica, Unidad de Hipertensión Arterial y Riesgo Cardiovascular, Hospital Escuela Eva Perón, Granadero Baigorria, Argentina; Asociación de Hipertensión Arterial de Rosario, Rosario, Argentina. Electronic address: albertinaghelfi@hotmail.com., Ferretti MV; Asociación de Hipertensión Arterial de Rosario, Rosario, Argentina; Clínica Médica, Sanatorio Norte, Rosario, Argentina., Staffieri GJ; Asociación de Hipertensión Arterial de Rosario, Rosario, Argentina; Unidad de Hipertensión Arterial, Grupo Oroño, Rosario, Argentina.
Jazyk: Spanish; Castilian
Zdroj: Hipertension y riesgo vascular [Hipertens Riesgo Vasc] 2021 Jul-Sep; Vol. 38 (3), pp. 133-147. Date of Electronic Publication: 2021 Feb 22.
DOI: 10.1016/j.hipert.2021.01.002
Abstrakt: Hypertension (HTN) in pregnancy is defined as systolic blood pressure ≥ 140 and/or diastolic blood pressure ≥ 90 mmHg. Based on the values, it is classified as non-severe (< 160/110 mmHg) and severe (≥ 160/110 mmHg). Before starting treatment in non-severe HTN, white- coat HTN should be ruled out. If outpatient management is possible, pharmacological initiation is suggested with sustained high values, avoiding < 120/80 mmHg. Safe drugs during pregnancy are methyldopa, labetalol, and nifedipine-retard. The use of nifedipine-XL or amlodipine can be considered with a lower level of evidence of safety. Diuretics, atenolol, and other beta-blockers for antihypertensive purposes is not recommended in this period. Renin-angiotensin-aldosterone system inhibitors are strictly contraindicated. In postpartum and breastfeeding, the same therapeutic regimen used during pregnancy can be maintained, trying early withdrawal of methyldopa. During puerperium, amlodipine and enalapril are safe, with minimal excretion in breast milk.
(Copyright © 2021 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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