Evaluation of Pharmacological Treatment in Patients with Chronic Hypertension Associated with Pregnancy

Abstract

Introduction: The diagnosis of chronic hypertension during pregnancy is difficult in a patient who does not report a history of hypertension.
Objective: To characterize the management of these patients from the pharmacological point of view.
Method: A retrospective descriptive study was carried out on the use of medications, indication-prescription type, from 2015 to 2017. Six hundred eighty seven (687) pregnant women with chronic arterial hypertension was the universe of this study. These subjects are from Villa Clara and were patients of the consultation of hypertension and pregnancy at Mariana Grajales Gynecobstetric Hospital in Santa Clara. Two hundred forty two (242) patients were select to form the sample by simple random sampling that represented 35.2% of the study universe.
Results: In similar proportion, we found patients with hypertension before pregnancy and diagnosed in the first 22 weeks. In both groups, the main risk factors were pregestational obesity in 79% and cardio metabolic risk in 74.4%. Monotherapy predominated in the evaluation of the pharmacological treatment of these patients. There was a readjustment of the initial doses. The treatments indicated in the primary health care were modified. In general, the evaluation of the treatment was inadequate in the majority of the cases.
Conclusions: Patients with chronic hypertension associated with pregnancy have risk factors for preeclampsia-eclampsia. Pregestational obesity and cardiometabolic risk are also contributing risks. The majority of patients (104) required monotherapy. In addition, they have taken treatments that have required reorganization in subsequent consultations. The evaluation of the treatment was inadequate in most cases.