Peripartum Management of Hypertension. A Position Paper of the ESC Council on Hypertension and the European Society of Hypertension

Δημοσίευση στις 2019 Dec 16 στο PubMed: https://pubmed.ncbi.nlm.nih.gov/31841131/?from_term=tsioufis&from_sort=date&from_size=200&from_pos=11

Renata Cífková

, Mark R Johnson

, Thomas Kahan

, Jana Brguljan

, Bryan Williams

, Antonio Coca

, Athanasios Manolis

, Costas Thomopoulos

, Claudio Borghi
0
, Costas Tsioufis

, Gianfranco Parati

, Isabella Sudano

, Richard J McManus

, Bert-Jan H van den Born

, Vera Regitz-Zagrosek

, Giovanni de Simone

2019 Dec 16[Online ahead of print]

Renata Cífková^{1

2}, Mark R Johnson³, Thomas Kahan⁴, Jana Brguljan⁵, Bryan Williams⁶, Antonio Coca⁷, Athanasios Manolis⁸, Costas Thomopoulos⁹, Claudio Borghi¹⁰, Costas Tsioufis¹¹, Gianfranco Parati¹², Isabella Sudano¹³, Richard J McManus¹⁴, Bert-Jan H van den Born¹⁵, Vera Regitz-Zagrosek¹⁶, Giovanni de Simone¹⁷

Affiliations

¹ Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Prague, Czech Republic.
² Department of Medicine II, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic.
³ Institute of Reproductive and Developmental Biology, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, United Kingdom.
⁴ Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Stockholm, Sweden.
⁵ University Medical Centre Ljubljana, Division of Internal Medicine, Department of Hypertension, Medical Faculty, Ljubljana, Slovenia.
⁶ UCL Institute of Cardiovascular Sciences, University College London, London, United Kingdom.
⁷ Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clinic, University of Barcelona, Spain.
⁸ Department of Cardiology, Asklepeion General Hospital, Athens, Greece.
⁹ Department of Cardiology, Helena Venizelou General & Maternal Hospital, Athens, Greece.
¹⁰ Department of Medicial and Surgical Sciences, University of Bologna, Bologna, Italy.
¹¹ First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
¹² Department of Medicine and Surgery, University of Milano-Bicocca; Istituto Auxologico Italiano, IRCCS, Cardiology Unit and Department of Cardiovascular, Neural and Metabolic Sciences, S.Luca Hospital, Milan, Italy.
¹³ University Heart Center Zurich, Department of Cardiology, University Hospital and University of Zurich, Switzerland.
¹⁴ Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
¹⁵ Departments of Internal and Vascular Medicine, Department of Public Health, Amsterdam University Medical Centre, Amsterdam, The Netherlands.
¹⁶ Berlin Institute for Gender in Medicine and CCR, Charité University Medicine Berlin, and DZHK, partner site Berlin, Germany.
¹⁷ Hypertension Research Center & Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.

Item in Clipboard

Renata Cífková et al.

Eur Heart J Cardiovasc Pharmacother.

2019

Authors

Affiliations

¹ Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Prague, Czech Republic.
² Department of Medicine II, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic.
³ Institute of Reproductive and Developmental Biology, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, United Kingdom.
⁴ Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Stockholm, Sweden.
⁵ University Medical Centre Ljubljana, Division of Internal Medicine, Department of Hypertension, Medical Faculty, Ljubljana, Slovenia.
⁶ UCL Institute of Cardiovascular Sciences, University College London, London, United Kingdom.
⁷ Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clinic, University of Barcelona, Spain.
⁸ Department of Cardiology, Asklepeion General Hospital, Athens, Greece.
⁹ Department of Cardiology, Helena Venizelou General & Maternal Hospital, Athens, Greece.
¹⁰ Department of Medicial and Surgical Sciences, University of Bologna, Bologna, Italy.
¹¹ First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
¹² Department of Medicine and Surgery, University of Milano-Bicocca; Istituto Auxologico Italiano, IRCCS, Cardiology Unit and Department of Cardiovascular, Neural and Metabolic Sciences, S.Luca Hospital, Milan, Italy.
¹³ University Heart Center Zurich, Department of Cardiology, University Hospital and University of Zurich, Switzerland.
¹⁴ Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
¹⁵ Departments of Internal and Vascular Medicine, Department of Public Health, Amsterdam University Medical Centre, Amsterdam, The Netherlands.
¹⁶ Berlin Institute for Gender in Medicine and CCR, Charité University Medicine Berlin, and DZHK, partner site Berlin, Germany.
¹⁷ Hypertension Research Center & Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.

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Abstract

Hypertensive disorders are the most common medical complications in the peripartum period associated with a substantial increase in morbidity and mortality. Hypertension in the peripartum period may be due to the continuation of pre-existing or gestational hypertension, de novo development of pre-eclampsia or it may be also induced by some drugs used for analgesia or suppression of postpartum haemorrhage. Women with severe hypertension and hypertensive emergencies are at high risk of life threatening complications, therefore, despite the lack of evidence-based data, based on expert opinion, antihypertensive treatment is recommended. Labetalol intravenously and metyldopa orally are then the two most frequently used drugs. Short-acting oral nifedipine is suggested to be used only if other drugs or iv access are not available. Induction of labour is associated with improved maternal outcome and should be advised for women with gestational hypertension or mild pre-eclampsia at 37 weeks᾽ gestation. This position paper provides the first interdisciplinary approach to the management of hypertension in the peripartum period based on the best available evidence and expert consensus.

Keywords:

antihypertensive drugs; gestational hypertension; hypertensive emergency; low dose of acetylsalicylic acid; pre-eclampsia; pre-existing hypertension.

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Κωνσταντίνος Τσιούφης

Ο Κωνσταντίνος Τσιούφης είναι Καθηγητής Καρδιολογίας στο Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών. Απόφοιτος του ’87 με βαθμό “ΑΡΙΣΤΑ”, εργάζεται στο Ιπποκράτειο Γενικό Νοσοκομείο Αθηνών με τα κύρια αντικείμενα ενασχόλησής του να είναι η υπέρταση και η επεμβατική καρδιολογία.

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