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Abstract
Objective: To evaluate the effects of the beta-adrenergic blocker pindolol on platelet function and pregnancy outcome in chronic hypertensive patients.
Methods: A placebo-controlled, prospective, randomized trial in 30 pregnant patients diagnosed as having chronic hypertension. Platelet aggregation and adenosine triphosphate (ATP) release were studied prior to and 7-10 days after pindolol treatment, and in the postpuerperal period.
Main Outcome Measure: A difference between the pindolol and placebo groups in platelet aggregation or release of ATP after in vitro exposure to adenosinediphosphate (ADP).
Results: No significant difference was demonstrated between the treatment and placebo groups in platelet aggregation or release of ATP after their in vitro exposure to ADP, epinephrine, or both. No significant ameliorating effect of the treatment on perinatal outcome was observed, although maternal diastolic blood pressure was better controlled in the pindolol-treated patients. The known effect of pregnancy in reducing the platelet aggregation response is supported. Platelet aggregation was lower in the first two trimesters (P < 0.001) and in the third trimester (P < 0.02) of pregnancy than during the postpuerperal period.
Conclusion: The possibility is raised of a relationship between the potency of an antihypertensive medication, administered to improve platelet function during pregnancy, and the perinatal outcome. This suggests that platelet aggregation and release may be used as potential tests for the selection of a better drug for management of chronic hypertension in pregnancy.