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Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: An open-label, randomized controlled trial

The Lancet Sep 28, 2019

Easterling T, Mundle S, Bracken H, et al. - Through a multicentre, parallel-group, open-label, randomized controlled trial conducted in two public hospitals in Nagpur, India on pregnant women (n = 2,307) who were aged at least 18 years, were pregnant with fetuses that had reached a gestational age of at least 28 weeks, needed pharmacological blood pressure control for severe hypertension (systolic blood pressure ≥ 160 mm Hg or diastolic blood pressure ≥ 110 mm Hg) and were able to swallow oral medications, for the management of severe hypertension in pregnancy, experts contrasted the efficiency and safety of three oral drugs, labetalol, nifedipine retard, and methyldopa. In most women, all oral antihypertensives decreased blood pressure to the reference range. As single drugs, nifedipine retard use led to a greater frequency of primary outcome accomplishment in comparison with labetalol or methyldopa use. For the treatment of severe hypertension in low-resource settings, all three oral drugs—methyldopa, nifedipine, and labetalol—were concluded as viable initial options.
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