Resistant Hypertension in Pregnancy: How to Manage?

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author BORTOLOTTO, Maria Rita FMUSP-HC
FRANCISCO, Rossana Pulcineli Vieira FMUSP-HC
ZUGAIB, Marcelo FMUSP-HC
dc.date.issued 2018
dc.identifier.citation CURRENT HYPERTENSION REPORTS, v.20, n.8, article ID 63, 8p, 2018
dc.identifier.issn 1522-6417
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/28167
dc.description.abstract The concept of resistant hypertension may be changed during pregnancy by the physiological hemodynamic changes and the particularities of therapy choices in this period. This review discusses the management of pregnant patients with preexisting resistant hypertension and also of those who develop severe hypertension in gestation and puerperium. The main cause of severe hypertension in pregnancy is preeclampsia, and differential diagnosis must be done with secondary or primary hypertension. Women with preexisting resistant hypertension may need pharmacological therapy adjustment. Several drugs can be used to treat severe hypertension, with exception of angiotensin-converting enzyme inhibitors and angiotensin II receptor antagonists. The most used drugs are methyldopa, beta-blockers, and calcium channel antagonists. There is a general agreement that severe hypertension must be treated, but there are still debates over the goals of the treatment. Delivery is indicated in viable pregnancies in which blood pressure control is not achieved with three drugs in full doses. Resistant hypertension may arise in postpartum. The management of resistant hypertension in pregnancy must regard the possible etiology, the fetal well-being, and the mother's risk. Good care is mandatory to reduce maternal mortality risk.
dc.language.iso eng
dc.publisher SPRINGER
dc.relation.ispartof Current Hypertension Reports
dc.rights restrictedAccess
dc.subject Antihypertensive agents; Hypertension/diagnosis; Hypertension; Pregnancy-induced/diagnosis; Hypertension; Pregnancy-induced/therapy; Preeclampsia; Puerperal disorders
dc.subject.other tight control; less-tight; preeclampsia; guidelines; disorders
dc.title Resistant Hypertension in Pregnancy: How to Manage?
dc.type article
dc.rights.holder Copyright SPRINGER
dc.description.group LIM/57
dc.identifier.doi 10.1007/s11906-018-0865-z
dc.identifier.pmid 29892919
dc.type.category review
dc.type.version publishedVersion
hcfmusp.author BORTOLOTTO, Maria Rita:HC:ICHC
hcfmusp.author FRANCISCO, Rossana Pulcineli Vieira:FM:MOG
hcfmusp.author ZUGAIB, Marcelo:FM:MOG
hcfmusp.origem.id WOS:000435082100001
hcfmusp.origem.id 2-s2.0-85048508046
hcfmusp.publisher.city NEW YORK
hcfmusp.publisher.country USA
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dc.description.index MEDLINE
dc.identifier.eissn 1534-3111
hcfmusp.citation.scopus 1
hcfmusp.citation.wos 1


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