Metoprolol in the Treatment DF Mild to Moderate Hypertension in Pregnancy-Effects on the Mother

Abstract

The benefits of antihypertensive drugs in the treatment of mild to moderate hypertension in pregnancy are disputed. In a placebo-controlled double-blind study, the effects of metoprolol in the treatment of pregnant women with blood pressures (BP) of ≤ 140/90 mmHg or an increase of 30/15 mmHg or more during pregnancy were evaluated. Fifty-two women with hypertension diagnosed before the 37th gestational week were randomly allocated to either treatment with metoprolol, a beta-1-selective adrenoceptor blocking agent, or placebo. The treatment groups were comparable concerning age, parity, gestational age at entry and pre-eclampsia at entry. The mothers with albuminuria and serum-uric acid concentrations ≥ 350 μmol1/1 before or during treatment formed the pre-eclamptic (PE) group (n=22), while the rest of the hypertensive women were regarded as “other” hypertensives (OH, n=30). Pulse rates decreased in the metoprolol treated group. Mean BP was significantly reduced during metoprolol treatment in the OH group but not in the PE group. Serum creatinine concentrations increased in the metoprolol treated PE group but not in the other groups. Serum urea concentrations increased in all groups except in the placebo treated OH group. The number of patients with preeclampsia before treatment and during treatment was the same in the actively treated group as in the placebo group. Treatment with metoprolol did not prolong pregnancy.

We conclude, that metoprolol in mild to moderate hypertension in pregnancy lowers pulse rate and decreases BP in hypertensive pregnant patients not suffering from pre-eclampsia. Metoprolol treatment of hypertensive pregnant women does not prevent the development of pre-eclampsia.