Treatment of postpartum arterial hypertension with losartan in severe preeclampsia.

Abstract

Postpartum hypertension increases the risk of acute and chronic complications in patients with preeclampsia. Losartan may be a useful drug alternative. To determine the results of treatment of postpartum hypertension with losartan in patients with severe preeclampsia. Uncontrolled clinical trial in 49 patients with severe preeclampsia. After gestational interruption, two groups were formed: group A (n = 24) received the standard antihypertensive regimen (methyldopa 1500 mg/day, hydralazine 200 mg/day, metoprolol 200 mg/day), and group B (n = 25) the same treatment plus losartan 100 mg/day for 90 days. In both groups, methyldopa, hydralazine and metoprolol was reduced or suspended in that order; in group B, losartan was maintained with the same or half the dose without suspending it. Baseline and final values (day 90) of systolic (SBP) and diastolic blood pressure (DBP) were compared. Descriptive and inferential statistics were applied (Student's t test for paired samples, Mann-Whitney U test, Wilcoxon's signed rank test). It was significant a p < 0.05. Group A: baseline SBP 135.46 ± 13.88 vs. final 109.76 ± 10.54 mmHg (p < 0.001) and basal DBP 85.71 ± 10.17 vs. final 72.14 ± 10.55 mmHg (p < 0.001). Group B: basal SBP 135.84 ± 14.39 vs. final 110.68 ± 9.79 mmHg (p < 0.001) and baseline DBP 83.08 ± 9.58 vs. final 72.61 ± 9.16 mmHg (p < 0.001). Both treatments similarly reduced SBP and DBP at the 90-day measurement.