| Research question | In women who require treatment for chronic hypertension in pregnancy, what is the effectiveness and safety of antihypertensive agents (compared in head-to-head trials) in improving maternal and perinatal outcomes? |
|---|---|
| Importance to ‘patients’ or the population | Use of treatments shown to be effective and safe in pregnancy may reduce the risk of adverse events due to high blood pressure, reduce the burden of monitoring for the woman and reduce the incidence of adverse effects for both the woman and her baby. |
| Relevance to NICE guidance | The committee searched for evidence on this topic but found no high-quality evidence. The committee therefore made the recommendations to consider treatment based on limited available evidence, ensuring that choices of medication take into account pre-existing treatment and the safe use of medicines in pregnancy. However, clinical trials in this area would allow more definitive evidence-based recommendations to be made. |
| Relevance to the NHS | Evidence in this area would lead to better care of women with hypertension in pregnancy, may reduce the need for admission and progression to pre-eclampsia, and lead to better outcomes for both women and their babies (with fewer adverse effects). |
| National priorities | The Department of Health and Social Care Single Departmental Plan (May 2018) aims to reduce variation in health outcomes, and reduce maternal deaths by 20% by 2020 and 50% by 2025. This research recommendation is in response to an identified need in the population. |
| Current evidence base | Lack of evidence; some low or very low quality evidence available. |
| Equality | Pregnant women are entitled to safe pharmacological treatment of their chronic hypertension, without risk to either themselves or their baby |
From: Evidence review for interventions for chronic hypertension
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.