Nifedipine or prazosin as a second agent to control early severe hypertension in pregnancy: A randomised controlled trial

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dc.contributor.authorHall D.R.
dc.contributor.authorOdendaal H.J.
dc.contributor.authorSteyn D.W.
dc.contributor.authorSmith M.
dc.date.accessioned2011-05-15T16:15:47Z
dc.date.available2011-05-15T16:15:47Z
dc.date.issued2000
dc.description.abstractObjective. To determine whether nifedipine or prazosin is the more appropriate second-line antihypertensive agent in pregnancy. Design. Randomised controlled trial. Setting. Tygerberg Hospital, a tertiary referral centre. Population. Women with early, severe pre-eclampsia or hypertension in pregnancy, whose blood pressure could not be adequately controlled by methyldopa 2 g/day, but were otherwise stable. Methods. Nifedipine or prazosin were given and increased as necessary in a stepwise fashion. Once the maximum dose was reached, the other drug was added in a crossover pattern. Failure to control blood pressure, or the onset of maternal/fetal complications were indications for delivery. Patients reaching a minimum gestation of 34 weeks without complications were delivered electively. Main outcome measures. Antenatal days gained; major maternal complications and perinatal survival. Results. Days gained on the second antihypertensive agent did not differ significantly (P = 0.9), while more days were gained using nifedipine as the crossover 'third agent' (P = 0.01). In the nifedipine group better renal function was recorded, but more cases with isolated low platelet counts occurred. More cases of pulmonary oedema as well as more nonviable mid-trimester and third trimester intrauterine deaths occurred in the prazosin group. Conclusion. Nifedipine and prazosin as second agents allowed comparable amounts of time to be gained, although this changed when used as crossover third-line agents. The efficacy and safety of nifedipine in this study are consistent with the results of other studies. A greater number of intrauterine deaths occurred in the prazosin group.
dc.description.versionArticle
dc.identifier.citationBritish Journal of Obstetrics and Gynaecology
dc.identifier.citation107
dc.identifier.citation6
dc.identifier.issn03065456
dc.identifier.urihttp://hdl.handle.net/10019.1/13491
dc.subjectantihypertensive agent
dc.subjectmethyldopa
dc.subjectnifedipine
dc.subjectprazosin
dc.subjectadult
dc.subjectarticle
dc.subjectblood pressure regulation
dc.subjectclinical trial
dc.subjectcontrolled clinical trial
dc.subjectcontrolled study
dc.subjectfemale
dc.subjectfetus death
dc.subjecthuman
dc.subjecthypertension
dc.subjectkidney function
dc.subjectmajor clinical study
dc.subjectpreeclampsia
dc.subjectpriority journal
dc.subjectrandomized controlled trial
dc.subjectthrombocyte count
dc.subjectAntihypertensive Agents
dc.subjectBlood Pressure
dc.subjectDrug Therapy, Combination
dc.subjectFemale
dc.subjectHumans
dc.subjectHypertension
dc.subjectNifedipine
dc.subjectPrazosin
dc.subjectPre-Eclampsia
dc.subjectPregnancy
dc.subjectPregnancy Complications, Cardiovascular
dc.subjectPregnancy Outcome
dc.subjectVasodilator Agents
dc.titleNifedipine or prazosin as a second agent to control early severe hypertension in pregnancy: A randomised controlled trial
dc.typeArticle
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