A comparative analysis of antihypertensive drugs for hypertension and gestational hypertension among women in tertiary care hospitals in Lahore, Pakistan

Abstract

Hypertension, characterized by persistently elevated blood pressure, poses severe risks, such as heart damage, artery hardening, and reduced blood and oxygen flow to the heart, which can also lead to kidney damage and stroke. Antihypertensive therapy for pregnant women differs from that for nonpregnant women because most antihypertensive medications used for nonpregnant hypertensive women are contraindicated for pregnant hypertensive patients. This study aimed to compare therapeutic regimens for treating hypertension between pregnant and nonpregnant women in various healthcare facilities. This cross-sectional study was conducted at several tertiary care hospitals in Lahore, Pakistan, recruiting 500 pregnant or nonpregnant female patients aged 18-55 years with hypertension. The data were collected through structured interviews and medical records reviews. Descriptive statistics and chi-square tests were used to analyze the data, with significance set at p < 0.05. A significant difference in area of residence was observed, with 83.2% of nonpregnant women residing in urban areas compared to 52.4% of pregnant women residing in urban areas. A systolic blood pressure between 120 and 139 mmHg was observed in 82.8% of pregnant women, compared to 51.2% of nonpregnant women (p < 0.001). Diastolic blood pressure between 80-99 mmHg was observed in 84.4% of pregnant women and 76.8% of nonpregnant women (p < 0.001). CVDs were more prevalent among nonpregnant women (38.8%), while anemia was more common in pregnant women (25.6%). Pregnant women were primarily prescribed methyldopa (58%), labetalol (56%), and amlodipine (40.4%), whereas nonpregnant women were more frequently prescribed valsartan (39.2%), metoprolol (28.8%), nebivolol (28%), and a combination of furosemide and spironolactone (24%). This study highlighted significant differences in comorbid conditions and antihypertensive treatment regimens between pregnant and nonpregnant women, emphasizing the need for tailored hypertension management approaches. Moreover, safer antihypertensive agents were prescribed to both groups, considering the Food and Drug Administration (FDA) drug categories and the observed comorbid conditions.