Beta-blockers appear to be no more effective and probably equally as safe .
It is unusual for women to change drugs due to side effects .
REVIEW ER 'S CONCLUSIONS Improvement in control of maternal blood pressure with use of beta-blockers would be worthwhile only if it were reflected in substantive benefits for mother and /or baby , and none have been clearly demonstrated .
Large r and omised trials are needed to determine whether antihypertensive therapy in general ( rather than beta-blocker therapy specifically ) results in greater benefit than risk , for treatment of mild-moderate pregnancy hypertension .
BACKGROUND Antihypertensives , such as beta-blockers , are used for pregnancy hypertension in the belief these will improve outcome for mother and baby .
OBJECTIVES To assess whether oral beta-blockers are better than placebo , or no beta-blocker , and have advantages over other antihypertensives , for women with mild to moderate pregnancy hypertension .
Prevention of preeclampsia: a randomized trial of atenolol in hyperdynamic patients before onset of hypertension.
OBJECTIVE To determine if assessment of maternal hemodynamics could predict women at risk for the development of preeclampsia , if treatment directed at hemodynamic abnormalities before the onset of hypertension could prevent preeclampsia , and if mothers could be treated in a way that protects fetal growth . METHODS A double-blinded , r and omized controlled trial was conducted . Subjects were considered to be at risk for preeclampsia if their cardiac output was greater than 7.4 L/min before 24 weeks ' gestation . Nulliparous and diabetic subjects at risk were treated with 100 mg of atenolol or placebo .  Cardiac output was measured by Doppler technique . Inulin and para-aminohippurate clearances were performed . RESULTS Treatment with atenolol reduced the incidence of preeclampsia from 5 of 28 ( 18 % ) to 1 of 28 ( 3.8 % ) , ( P = .04 ) . Nulliparous women determined to be at risk for preeclampsia were similar to diabetic women at risk . Each was significantly heavier and had inulin and para-aminohippurate clearances greater than the control group . Treatment with atenolol was associated with infants weighing 440 g less than infants in the nulliparous placebo group , ( P = .02 ) . No effect on birth weight was seen in the diabetic patients . Mothers of the smallest infants who were treated with atenolol could be identified by unexpectedly large reductions in cardiac output . CONCLUSION Measurement of cardiac output in the second trimester identified women at risk for preeclampsia . Treatment with atenolol decreased the incidence of preeclampsia .  Nulliparous and diabetic women at risk for preeclampsia were similar with regard to maternal hemodynamics , maternal weight , and renal function . Treatment with atenolol was associated with reduced infant birth weight
Beta-blockers appear to be no more effective and probably equally as safe .
It is unusual for women to change drugs due to side effects .
REVIEW ER 'S CONCLUSIONS Improvement in control of maternal blood pressure with use of beta-blockers would be worthwhile only if it were reflected in substantive benefits for mother and /or baby , and none have been clearly demonstrated .
Large r and omised trials are needed to determine whether antihypertensive therapy in general ( rather than beta-blocker therapy specifically ) results in greater benefit than risk , for treatment of mild-moderate pregnancy hypertension .
BACKGROUND Antihypertensives , such as beta-blockers , are used for pregnancy hypertension in the belief these will improve outcome for mother and baby .
OBJECTIVES To assess whether oral beta-blockers are better than placebo , or no beta-blocker , and have advantages over other antihypertensives , for women with mild to moderate pregnancy hypertension .