Nifedipine outperforms labetalol: A comparative analysis of hypertension management in black pregnancies
Recommended Citation
Smith N, Kwon Kim S, Goyert G, Lin CH, Rose C, and Pitts DS. Nifedipine outperforms labetalol: A comparative analysis of hypertension management in black pregnancies. Pregnancy Hypertens 2024; 37:101147.
Document Type
Article
Publication Date
9-1-2024
Publication Title
Pregnancy Hypertens
Abstract
BACKGROUND: Nifedipine has previously exhibited superior efficacy to labetalol in managing hypertension in the non-pregnant Black population, establishing itself as a first-line treatment option. However, the unique challenges of hypertension during pregnancy, especially prevalent in Black individuals, remain underexplored in terms of effective medication choices. This gap highlights the need for targeted research on antihypertensive efficacy specifically within this population.
OBJECTIVE: This study aims to evaluate the effectiveness of nifedipine versus labetalol in managing blood pressure in Black pregnancies. The primary measure is the mean systolic and diastolic blood pressure trajectories throughout pregnancy, determining the superiority of nifedipine in this context.
STUDY DESIGN: A retrospective cohort study was conducted at a multi-center institution in the metropolitan Detroit area, encompassing data from 1,235 Black pregnancies affected by chronic hypertension between 2015 and 2022. Mean blood pressure trajectories during pregnancy were fit by linear mixed effects model with a random intercept and time effect.
RESULTS: Patients on nifedipine had an estimated 2.08 mmHg lower mean systolic and 1.60 mmHg lower mean diastolic blood pressure compared to those on labetalol, with significant p-values of 0.040 and 0.028. Additionally, nifedipine users were less likely to need increased doses, with an odds ratio of 0.28 (95 % CI: 0.19-0.40, p < 0.001) compared to labetalol users.
CONCLUSION: This study provides compelling evidence that nifedipine outperforms labetalol in managing blood pressure during Black pregnancies. These findings suggest that the initiation of nifedipine should be considered in the management of chronic hypertension among Black pregnant individuals, offering a potentially more effective treatment option.
Medical Subject Headings
Humans; Labetalol; Nifedipine; Female; Pregnancy; Retrospective Studies; Antihypertensive Agents; Adult; Black or African American; Hypertension, Pregnancy-Induced; Blood Pressure; Treatment Outcome
PubMed ID
39153458
Volume
37
First Page
101147
Last Page
101147
