Antihypertensive Use in Pregnancy Increasing
(HealthDay News) – The prevalence of antihypertensive use in pregnancy is approaching 5% and is increasing, according to a study published online Sept 10 in Hypertension.
Brian T. Bateman, MD, from Brigham and Women's Hospital in Boston, and colleagues analyzed maternal exposure to antihypertensive medications using data from Medicaid pharmacy claim files from 2000–2007, creating a cohort of 1,106,757 Medicaid patients.
Of the participants, 4.4% (48,453 women) were exposed to antihypertensive medications during pregnancy. The researchers found that during the study period the prevalence of antihypertensive use increased from 3.5–4.9%. Compared to nonusers, users of antihypertensive medications were older, more likely to be white or black, and more likely to have comorbid diabetes mellitus and renal disease. Exposure to antihypertensives was noted for 1.9% of pregnant women during the first trimester, 1.7% during the second trimester, and 3.2% during the third trimester. Patients were exposed to a wide range of antihypertensive medications. Angiotensin-converting enzyme inhibitors, which are contraindicated in late pregnancy, were used by 4.9% of users in the second trimester and 1.1% in the third trimester.
"Our data suggest that the exposure to antihypertensive medications in pregnancy is relatively common and increasing," the authors write. "Research investigating the comparative safety and efficacy of antihypertensive therapy in pregnancy is urgently needed to define the optimal approach to therapy."