Early Vascular Adjustments During Hypertensive Pregnancy
Status:
Recruiting
Trial end date:
2023-04-01
Target enrollment:
Participant gender:
Summary
Paradoxical fetal and maternal results of studies have led to inconsistent use of
antihypertensive drugs or no treatment at all in mild to moderate gestational hypertension in
the Netherlands. However, none of the studies have taken the individual maternal circulatory
state or the contemplated blood pressure response into account. Hypertension may be
accompanied by high (hyperdynamic vasodilated profile), normal (normodynamic profile) of low
(hypodynamic vasoconstrictive profile) cardiac output, and preeclampsia is not restricted to
one circulatory profile. Therefore antihypertensive drugs should be viewed upon as correctors
of the hemodynamic state rather than solely reducers of blood pressure. Without taking the
maternal hemodynamic profile and condition into account, generic antihypertensive treatment
can be expected to result in disappointing, inadequate and paradoxical results. The
investigators hypothesize that in mild to moderate hypertension, personalized hemodynamically
guided antihypertensive therapy (with target systolic and diastolic blood pressure
<130/80mmHg), prevents the progression to severe hypertension and/or preeclampsia compared to
no treatment, without the alleged side-effects.