Publication:

A prospective observational study to compare efficacy and safety of methyldopa and nifedipine in management of moderate gestation hypertension

Background Hypertensive disorder in pregnancy is one of the most common complications of pregnancy worldwide. It is associated with maternal mortality and morbidity as well as perinatal mortality. Antihypertensive drugs are often used to lower blood pressure with the aim of preventing its progression to adverse outcomes for the mother and the fetus. The risk of developing severe hypertension is reduced to half by using antihypertensive medications. Studies have been done using various antihypertensive in hypertensive disorders of pregnancy. But there are very few studied comparing nifedipine and methyldopa in hypertensive disorders of pregnancy where majority of the studies are evaluated for short duration. Hence we have undertaken this study to compare the efficacy and safety of methyldopa and nifedipine in patient with moderate gestational hypertension.

Methods This is a prospective observational study where pregnant patients with moderate gestational hypertension either on oral nifedipine 10 mg t.i.d. or on methyl-dopa 250 mg t.i.d. were enrolled during 6 month period. Data at week one and week four were observed along with side effects. Reduction in systolic and diastolic blood pressure from baseline and occurrence of side effects were studied. The statistical significance was at P < 0.05.

Results The mean reduction of systolic/diastolic BP with methyldopa in four weeks was 17/13 mmHg as compared to nifedipine being 18.5/14.5 in four week. There was significant reduction in systolic blood pressure in nifedipine group compared to methyldopa group at four weeks (p-0.04). Both treatments were well tolerated with minimal side effects.

Conclusions Methyldopa and Nifedipine are equally effective in controlling blood pressure in moderate gestational hypertension with minimal side effects. However, nifedipine can be preferred over methyldopa as it showed significant reduction in systolic blood pressure at four weeks.