Abstract P181: Hypertension Treatment Disruption During Pregnancy Among Women With Chronic Hypertension

Autor: Rod L. Walker, T. Craig Cheetham, Kristi Reynolds, Susan M. Shortreed, Victoria L. Holt, Lyndsay A. Avalos, Lu Chen, Aruna Kamineni, Sascha Dublin, Thomas R. Easterling
Rok vydání: 2018
Předmět:
Zdroj: Hypertension. 72
ISSN: 1524-4563
0194-911X
DOI: 10.1161/hyp.72.suppl_1.p181
Popis: Objective: In the U.S., 1.3 million women of reproductive age take antihypertensive medications for chronic hypertension. However, some of these medications are considered unsafe during pregnancy. We evaluated the burden of switching and stopping medications during pregnancy among women receiving treatment for chronic hypertension. Study Design: We identified a population-based cohort of women with chronic hypertension who received antihypertensive medications within 120 days before pregnancy and gave birth to a singleton between 2005 and 2014 within three Kaiser Permanente regions. We characterized women’s antihypertensive medication use from 120 days before pregnancy through delivery. We ascertained the highest systolic and diastolic blood pressures in the 120 days before the start of pregnancy and supplemented these values with measures up through 8 weeks’ gestation when pre-pregnancy values were missing. Results: 5,782 pregnant women were included. Prior to pregnancy, the most commonly used medication classes were thiazide diuretics (2,370/5,782, 41%), beta-blockers (1,569/5,782, 27%) and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) (1,391/5,782, 24%). In contrast, the predominant medications during pregnancy were labetalol (2,165/5,782, 37%) and methyldopa (1,593/5,782, 28%). During pregnancy, 18% of the cohort (1,037/5,782) had no antihypertensive medication fills. Women taking ACEI/ARBs or thiazides before pregnancy were the most likely to have no medication fills in pregnancy (23% and 20%, respectively). Many women (n=881) had at least one severe high BP (SBP ≥160 or DBP ≥110) before pregnancy, and in this group, 15% (132/881) filled no medications throughout pregnancy. Conclusion: Women with chronic hypertension frequently stop antihypertensive medications during pregnancy, even women with a severely high BP documented before pregnancy. Research is needed to understand impact of these treatment interruptions on pregnancy outcomes and women’s long-term health.
Databáze: OpenAIRE
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