Managing Hypertension While Pregnant

High blood pressure during pregnancy means reconsidering what medications to take

/ Author:  / Reviewed by: Chris Galloway, M.D.

(RxWiki News) If you have a chronic condition and become pregnant, it may mean different treatment during the pregnancy. High blood pressure is one such condition, and it's becoming more common.

A recent study found that the number of pregnant women taking medication for high blood pressure is increasing.

However, the impact of these drugs on the women's unborn children isn't always certain.

"Discuss meds during pregnancy with your OB/GYN."

The study, led by Brian T. Bateman, MD, an assistant professor of anesthesia at Harvard Medical School, looked at how many pregnant women are taking blood pressure medications, including types that are known to cause problems for the baby.

Dr. Bateman's study looked for all pregnancies that resulted in a birth among Medicaid claims from 2000 to 2007.

Of the just over 1.1 million births in Medicaid patients that they found, 48,453 filled prescriptions for high blood pressure medications at least once during their pregnancy.

That's a rate of just over 4 percent of pregnant women who were taking medications for high blood pressure across the whole study period.

They also saw an increase in the usage of these drugs over the study period. While the rate was 3.5 percent in the first year included in the study, it had risen to 4.9 percent by 2007.

Women taking high blood pressure medications tended to be older, tended to be white or black rather than Latina or Asian and were more likely to also have diabetes or renal disease.

Across the full study period, 1.9 percent of the women took the medications during their first trimester, 1.7 percent took them during their second trimester and 3.2 percent took them during the third trimester.

Some blood pressure medications, called ACE inhibitors or ARBs, increase risk the risk of birth defects and other problems for both a pregnant woman and her child.

The study found that, of all the women taking medications for hypertension, 928 (4.9 percent) took ACE inhibitors during the second trimester, and 383 (1.1 percent) took them during the third trimester.

ACE inhibitors include benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril, (Aceon), quinapril (Accupril), ramipril (Altace) and trandolapril (Mavik).

The authors said that the increasing number of women taking high blood pressure medications during pregnancy, and the vast differences in the types of medication they are taking, mean that more research is needed to know what medications are safe and how to treat these women while pregnant.

The study was published September 10 in the journal Hypertension. The research was funded by the National Institutes of Health and the Agency for Healthcare Research and Quality. The authors reported no conflict disclosures.

Reviewed by: 
Review Date: 
September 7, 2012
Last Updated:
September 10, 2012