Published online before print February 10, 2003, doi: 10.1161/01.HYP.0000054981.03589.E9
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(Hypertension. 2003;41:437.)
© 2003 American Heart Association, Inc.
Scientific Contributions |
Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy
From the Department of Obstetrics, Gynecology and Reproductive Sciences, Graduate School of Public Health, University of Pittsburgh, and Magee-Womens Research Institute (J.M.R.), Pittsburgh, Pa; Heart Development, Function and Failure Scientific Research Group, Division of Heart and Vascular Disease (G.D.P.), and Division of Epidemiology and Clinical Applications (J.A.C.), National Heart, Lung, and Blood Institute/National Institutes of Health, Bethesda, Md; and Department of Obstetrics & Gynecology and Medicine, Division of Biological Sciences, The Pritzker School of Medicine (M.D.L.), University of Chicago, Ill.
Correspondence to James M. Roberts, MD, 204 Craft Avenue, Suite 610, Pittsburgh, PA 15213. E-mail rsijmr{at}mail.magee.edu
A Working Group on Research in Hypertension in Pregnancy was recently convened by the National Heart, Lung, and Blood Institute to determine the state of knowledge in this area and suggest appropriate directions for research. Hypertensive disorders in pregnancy, especially preeclampsia, are a leading cause of maternal death worldwide and even in developed countries increase perinatal mortality rates 5-fold. Much has been learned about preeclampsia, but gaps in the knowledge necessary to direct therapeutic strategies remain. Oxidative stress is a biologically plausible contributor to the disorder that may be amenable to intervention. Hypertension that antedates pregnancy (chronic hypertension) bears many similarities to hypertension in nonpregnant women, but the special setting of pregnancy demands information to guide evidence-based therapy. The recommendations of the Working Group are to attempt a clinical trial of antioxidant therapy to prevent preeclampsia that is be complemented by mechanistic research to increase understanding of the genetics and pathogenesis of the disorder. For chronic hypertension, clinical trials are recommended to direct choice of drugs, evaluate degree of control, and assess implications to the mother and fetus. Recommendations to increase participation in this research are also presented.
Key Words: hypertension, pregnancy • preeclampsia • pregnancy • research • oxidative stress • mortality
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