Use of Multiple Antihypertensive Agents Has Increased in Preeclampsia

HealthDay News — Use of antihypertensive treatments during delivery hospitalizations in women with preeclampsia has increased since 2006, according to a study published in Obstetrics & Gynecology.

Kirsten L. Cleary, MD, from Columbia University in New York City, and colleagues performed a retrospective cohort study to evaluate antihypertensive drugs dispensed during delivery hospitalizations complicated by preeclampsia from 2006 to 2015. Overall, 239,454 patients were included in the analysis, with 126,595 women having mild, 31,628 having superimposed, and 81,231 having severe preeclampsia.

The researchers found that overall, 105,409 women received a hypertensive agent. Receipt of oral labetalol increased from 20.3% in 2006 to 31.4% in 2014 for all patients with preeclampsia. Over the same time period, receipt of intravenous labetalol increased from 13.3% to 21.4%, hydralazine from 12.8% to 16.9%, and nifedipine from 15% to 18.2%. Patients receiving more than one medication increased from 16.5% to 25.8%. The proportion of patients receiving any antihypertensive increased from 37.8% in 2006 to 49.4% in 2015. 

For severe preeclampsia, rates of antihypertensive administration varied significantly by hospital. The risk for stroke in women with severe preeclampsia decreased from 13.5 per 10,000 deliveries (from 2006 to 2008) to 6 per 10,000 deliveries (from 2012 to 2014).

“Use of multiple antihypertensive agents to treat preeclamptic women increased over the study period for women with mild, superimposed, and severe preeclampsia,” the authors wrote.

Disclosures: One author disclosed financial ties to the pharmaceutical industry.

Reference

Cleary KL, Siddiq Z, Ananth CV, et al. Use of antihypertensive medications during delivery hospitalizations complicated by preeclampsia [published online February 5, 2018]. Obstet Gynecol. doi:10.1097/AOG.0000000000002479