怀孕期间抗高血压治疗对产后血压控制的影响
Samantha L Martin1, Hui-Chien Kuo, Kim Boggess
1Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, University of Pennsylvania, Philadelphia, Pennsylvania, University of Texas at Houston, Houston, Texas, Columbia University, New York, New York, Duke University, Durham, North Carolina, St. Luke's University Health Network, Bethlehem, Pennsylvania, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, Metro Health/Case Western University, Cleveland, Ohio, Indiana University, Indianapolis, Indiana, Drexel University College of Medicine, Philadelphia, Pennsylvania, University of Utah Health, Salt Lake City, Utah, University of Texas Southwestern, Dallas, Texas, Intermountain Healthcare, Salt Lake City, Utah, Ochsner Health, New Orleans, Louisiana, University of Texas Medical Branch, Galveston, Texas, St. Peters University Hospital, New Brunswick, New Jersey, Washington University in St. Louis, St. Louis, Missouri, University of Mississippi Medical Center, Jackson, Mississippi, Magee Women's Hospital and University of Pittsburgh, Pittsburgh, Pennsylvania, The Ohio State University, Columbus, Ohio, Rutgers University-Robert Wood Johnson Medical School, Brunswick, New Jersey, Medical College of Wisconsin, Milwaukee, Wisconsin, University of South Alabama at Mobile, Mobile, Alabama, Weill Cornell University, New York City, New York, Yale University, New Haven, Connecticut, NYU Langone Hospital-Long Island, Mineola, New York, University of Colorado, Aurora, Colorado, Emory University, Atlanta, Georgia, Denver Health, Denver, Colorado, University of California, San Francisco, San Francisco, California, NewYork-Presbyterian Queens Hospital, Flushing, New York, Stanford University, Stanford, California, Arrowhead Regional Medical Center, Colton, California, Tulane University, New Orleans, Louisiana, Wright State University and Miami Valley Hospital, Dayton, Ohio, University of Kansas Medical Center, Kansas City, Kansas, Medical University of South Carolina, Charleston, South Carolina, Vanderbilt University School of Medicine, Nashville, Tennessee, and Tufts University School of Medicine, Boston, Massachusetts; Beaumont Hospital, Grand Rapids, Michigan; the Center for Women's Reproductive Health, the Department of Biostatistics, the Department of Pediatrics, and the Department of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama; the Christiana Care Center for Women's and Children Health Research, Newark, Delaware; Zuckerberg San Francisco General Hospital, San Francisco, California; the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland; Virtua Health, Marlton, New Jersey; Oregon Health and Science University, Portland, Oregon; the Department of Obstetrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas; the Fetal Care Center of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Good Samaritan Hospital, Cincinnati, Ohio; the Department of Obstetrics, Gynecology and Women's Health, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, New Jersey; Obstetrics and Gynecology/Maternal-Fetal Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, Pennsylvania; and Obstetrics and Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio.
在怀孕期间治疗轻度慢性高血压可以改善产后血压控制. 抗高血压药物导致在分娩后的几周内更好地控制血压.
科学领域:
- 产科和妇科 产科和妇科
- 心脏病学 心脏病学
- 临床药理学 临床药理学
背景情况:
- 轻度慢性高血压影响了大量的怀孕.
- 怀孕期间高血压的有效管理对于母亲和胎儿的结果至关重要.
- 产后血压控制仍然是许多患有高血压的女性面临的挑战.
研究的目的:
- 为了比较孕妇轻度慢性高血压的产后血压 (BP) 控制,随机选择接受抗高血压治疗或不接受治疗.
- 评估怀孕期间开始的抗高血压治疗对实现产后目标血压低于140/90毫米的影响.
主要方法:
- 多中心,开放标签,随机对照CHAP试验的二次分析.
- 包括患有轻度慢性高血压 (BP < 160/105 mm Hg) 的孕妇参与者.
- 随机划分为主动治疗 (抗高血压药物) 或控制 (除非严重高血压,否则不接受治疗) 组,在产后6周随访时评估血压.
主要成果:
- 与对照组 (51.5%) 相比,接受积极治疗的参与者的比例更高,实现了产后血压控制 (56.7%).
- 活跃组中血压控制的调整后几率比为1.22 (95% CI,1.00-1.48).
- 产后抗高血压药物处方在活跃组显著高 (81.7%与58.4%),而药物不服药没有显著差异.
结论:
- 在怀孕期间对轻度慢性高血压的抗高血压治疗与在分娩后立即期间改善血压控制有关.
- 早期的抗高血压干预可能有利于在这一群体中管理产后高血压.
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