Gestational hypertension is a common syndrome of pregnancy that occurs in women at or after 20 weeks' gestation, with systolic blood pressure of 140 mmHg and/or diastolic blood pressure of 90 mmHg, and is the leading cause of maternal mortality, with complications in 3% to 10%. Gestational hypertension is a serious threat to the health and life of mothers and children, and the severity of the disease is positively correlated with the incidence of adverse maternal and infant outcomes, so early prevention and intervention are very important. In order to prevent serious maternal and fetal complications such as cardiovascular and cerebrovascular accidents and placental abruption, and reduce the perinatal mortality rate of mothers and children, it is particularly important to do a good job in the prevention and treatment of gestational hypertension. Medications are an important means of gestational hypertension.
Nicardipine
At present, commonly used antihypertensive drugs include adrenergic receptor blockers, calcium-channel blockers, and central adrenergic neuroblockers. Nicardipine is widely used as a water-soluble dihydropyridine calcium channel blocker in hypertensive disorders of pregnancy**.
One meta-analysis systematically reviewed the efficacy and safety of nicardipine alone or in combination** for gestational hypertension.
Nicardipine group: nicardipine alone** or nicardipine in combination with other antihypertensive drugs**.
Control group: other antihypertensive drugs.
Inclusion Criteria: Meet the diagnostic criteria for gestational hypertension, i.e., first onset of hypertension after 20 weeks of gestation, systolic blood pressure 140 mmHg and/or diastolic blood pressure 90 mmHg.
A total of 10 studies with a total of 1760 patients were included in the study.
Analyze the results
The results of meta-analysis of the included literature showed that nicardipine monotherapy** was as effective as the control group, but the combination of nicardipine** with gestational hypertension was associated with a better reduction in systolic blood pressure than the control group.
*Meta-analysis results of post-systolic blood pressure changes.
experimental: Nicardipine group;control: control group).
At the same time, the results of meta-analysis showed that the reduction of diastolic blood pressure in gestational hypertension with nicardipine alone and in combination with ** was better than that of the control group.
*Meta-analysis results of post-diastolic blood pressure changes.
experimental: Nicardipine group;control: control group).
In terms of the occurrence of adverse reactions, the results of meta-analysis showed that there was no significant difference in the incidence of adverse reactions between nicardipine alone or in combination** gestational hypertension and that of the control group.
*Results of meta-analysis of the occurrence of adverse reactions.
experimental: Nicardipine group;control: control group).
In summary, the results of meta-analysis showed that nicardipine, whether as a single agent** or in combination, reduced diastolic blood pressure during pregnancy better than other antihypertensive drugs, especially the combination of compressor and diastolic blood pressure. However, regardless of monotherapy or combination, the incidence of adverse reactions and neonatal asphyxia are similar to those of other antihypertensive drugs.
As a second-generation dihydropyridine calcium channel blocker, nicardipine is widely used in the control of acute severe hypertension and postoperative blood pressure. Compared with other calcium channel blockers, nicardipine is more selective for vascular smooth muscle, so its inhibitory effect on the heart is significantly less and less likely to cause reflex tachycardia than nifedipine.
The results of a number of studies have shown that nicardipine is a safe and effective antihypertensive drug, and nicardipine has a rapid and controllable antihypertensive effect with fast onset and short elimination half-life. While being highly effective and rapidly acting, no serious maternal and neonatal severity was reported***
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