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They are one of the three major causes of death in pregnancy (16%) along with post partum bleeding (13%) and puerperal infections (2%). [6] Hypertensive disorders during pregnancy, such as gestational hypertension, preeclampsia, and eclampsia, are a major contributor to maternal and fetal illness and death on a worldwide scale.
Drug treatment options are limited, as many antihypertensives may negatively affect the fetus. ACE inhibitors, angiotensin receptor blockers, and direct renin inhibitors are contraindicated in pregnancy as they are teratogenic. Methyldopa, hydralazine, nifedipine, and labetalol are most commonly used for severe pregnancy hypertension. [7]
Most drugs have other uses; sometimes the presence of other symptoms can warrant the use of one particular antihypertensive. Examples include: Age can affect the choice of medications. Current UK guidelines suggest starting patients over the age of 55 years first on calcium channel blockers or thiazide diuretics.
Labetalol, hydralazine and nifedipine are commonly used antihypertensive agents for hypertension in pregnancy. [6] ACE inhibitors and angiotensin receptor blockers are contraindicated as they affect fetal development. [53] The goal of treatment of severe hypertension in pregnancy is to prevent cardiovascular, kidney, and cerebrovascular ...
β-blockers, of which atenolol is mainly studied, provides weaker protection against stroke and mortality in patients over 60 years old compared to other antihypertensive medications. [ 24 ] [ 25 ] [ 26 ] [ 18 ] Diuretics may be associated with better cardiovascular and cerebrovascular outcomes than β-blockers in the elderly.
One study found that men with moderate-to-high levels of exhaustion had a 2.7-fold increased risk of heart attack within five years and a 2.25 higher risk within ten years. The study also found a ...
The antihypertensive activity of hydralazine was discovered by scientists at Ciba, who were trying to discover drugs to treat malaria; it was initially called C-5968 and 1-hydrazinophthalazine; Ciba's patent application was filed in 1945 and issued in 1949, [19] [20] [21] and the first scientific publications of its blood pressure-lowering ...
Duration of effect is dose-related; at recommended doses, antihypertensive and haemodynamic effects have been shown to be maintained for at least 24 hours. [21] [22] Enalapril has a slower onset of action than Captopril but a greater duration of action. However, unlike Captopril, Enalapril does not have a thiol moiety.