Table 6: Pharmacologic treatment of hypertensive disorders in pregnancy / CMAJ

Pharmacologic treatment of hypertensive disorders in pregnancy

Table 6: Recommendations related to treatment of hypertension and seizures in pregnancy issued by the Canadian Hypertension Society (CHS) and other international bodies*

Category CHS NHBPEPWG⁹⁹ ASSH¹⁰⁰

Nonsevere hypertension

BP readings at which to start treatment, mm Hg SBP > 139 or 149 or
DBP > 89 or 94 DBP > 99 SBP > 159 or
DBP > 89

Treatment goal, mm Hg DBP 80-90 -- SBP > 110

Drugs Methyldopa, labetalol, pindolol, oxprenolol, nifedipine Methyldopa Methyldopa, labetalol, oxprenolol, clonidine

Drugs to avoid ACE† inhibitor, angiotensin II receptor antagonist ACE inhibitor ACE inhibitor, diuretics

Severe hypertension

BP readings at which to start treatment, mm Hg SBP > 169 or
DBP >109 DBP > 104 SBP > 169 or
DBP > 114

Drugs Hydralazine, labetalol, nifedipine Hydralazine Hydralazine, labetalol nifedipine, diazoxide

Seizures

Drugs for prophylaxis Magnesium sulfate Magnesium sulfate Magnesium sulfate, phenytoin

Drugs for treatment Magnesium sulfate Magnesium sulfate Diazepam intravenously

*NHBPEPWG = National High Blood Pressure Education Program Working Group (US), ASSH = Australasian Society for Study of Hypertension.
†ACE = angiotensin-converting enzyme.

[Return to text]

| CMAJ November 1, 1997 (vol 157, no 9) / JAMC le 1er novembre 1997 (vol 157, no 9) |

CMA Webspinners / Les fileurs du Web de l'AMC

Table 6: Recommendations related to treatment of hypertension and seizures in pregnancy issued by the Canadian Hypertension Society (CHS) and other international bodies*
Category	CHS	NHBPEPWG⁹⁹	ASSH¹⁰⁰
Nonsevere hypertension
BP readings at which to start treatment, mm Hg	SBP > 139 or 149 or DBP > 89 or 94	DBP > 99	SBP > 159 or DBP > 89
Treatment goal, mm Hg	DBP 80-90	--	SBP > 110
Drugs	Methyldopa, labetalol, pindolol, oxprenolol, nifedipine	Methyldopa	Methyldopa, labetalol, oxprenolol, clonidine
Drugs to avoid	ACE† inhibitor, angiotensin II receptor antagonist	ACE inhibitor	ACE inhibitor, diuretics
Severe hypertension
BP readings at which to start treatment, mm Hg	SBP > 169 or DBP >109	DBP > 104	SBP > 169 or DBP > 114
Drugs	Hydralazine, labetalol, nifedipine	Hydralazine	Hydralazine, labetalol nifedipine, diazoxide
Seizures
Drugs for prophylaxis	Magnesium sulfate	Magnesium sulfate	Magnesium sulfate, phenytoin
Drugs for treatment	Magnesium sulfate	Magnesium sulfate	Diazepam intravenously
*NHBPEPWG = National High Blood Pressure Education Program Working Group (US), ASSH = Australasian Society for Study of Hypertension. †ACE = angiotensin-converting enzyme.