Antihypertensive therapy in the management of hypertension in pregnancy - a clinical double-blind study of pindolol

In order to investigate whether the early treatment of hypertension in pregnancy would have a beneficial effect on the outcome of the pregnancy, 60 women, presenting with a diastolic blood pressure of 85-99mmHg before the 35th week of pregnancy were randomly assigned either to treatment with pindolol or with a placebo. If DBP was consistently 100mmHg, the code was broken and patients receiving pindolol were given other antihypertensive agents and those in the placebo group were given pindolol initially followed by other agents in non-responders. The early treatment of hypertension was not associated with adverse effects in either mother or newborn. On the other hand, there were no beneficial effects either. Only 6 patients receiving pindolol required additional treatment whereas 15 patients receiving placebo required additional treatment (p==0.015). It is thus estimated that 50% of pregnant females with mild-moderate hypertension will eventually require antihypertensive therapy, while the remainder will be able to complete the pregnancy without treatment. Delaying the treatment of hypertension of pregnancy to DBP of 100mmHg is not associated with additional maternal or fetal risk and will reduce the number of patients receiving treatment to about half.