Clonidine Versus Captopril for Treatment of Postpartum Very High Blood Pressure
Condition: Preeclampsia
MeSH terms: Pre-Eclampsia; Hypertension
Study type: Interventional
Phase: Phase 4

Summary: 
      The postpartum period represents a stage of the pregnancy-puerperal still rarely addressed
      scientifically. There are no reports in the literature and concrete enough to elucidate
      important issues, especially in the field of hypertension and pregnancy.

      Searches based on current evidence concentrate their focus on the diagnosis of hypertensive
      disorders and treatment of these diseases maternofetais repercussions. However, the prognosis
      in the short and long term, as the BP outcome in mothers with severe preeclampsia, the most
      effective treatment for the control of hypertensive crisis and metabolic and cardiovascular
      events after two years of termination of pregnancy require further clarification.

      The main idea for developing this research came from the clinical experience with the use of
      captopril in Obstetric ICU IMIP. This drug has long been used in postpartum women with severe
      preeclampsia or chronic hypertension exacerbated by pregnancy for control of hypertensive
      crisis and keeping pressure levels. Following the technical standards of the institution and
      during his administration, there were reports of side effects such as dry cough and nausea,
      beyond the threshold dose of 150mg daily captopril was easily achieved hindering control the
      use of hypotensive.

      Alternative therapy, clonidine began to be used in mothers with some restriction on the use
      of ACE inhibitors and its hypotensive effect for peak pressure was satisfactory. What is not
      known yet is how long clonidine reduces high blood pressure and how long to leave stabilized
      compared to the use of captopril.

      There are no reports in the literature databases, no randomized clinical trials that prove
      the effectiveness of clonidine for the treatment of hypotensive pressure peaks in this
      particular group of patients, even in comparison with other classes of antihypertensive
      drugs, especially captopril, to this purpose.

      The investigators' primary assumption is that clonidine has better effectiveness in
      decreasing the frequency of pressure peaks when compared with captopril.
    

Detailed description: 
      The postpartum period represents a stage of the pregnancy-puerperal still rarely addressed
      scientifically. There are no reports in the literature and concrete enough to elucidate
      important issues, especially in the field of hypertension and pregnancy.

      Searches based on current evidence concentrate their focus on the diagnosis of hypertensive
      disorders and treatment of these diseases maternofetais repercussions. However, the prognosis
      in the short and long term, as the BP outcome in mothers with severe preeclampsia, the most
      effective treatment for the control of hypertensive crisis and metabolic and cardiovascular
      events after two years of termination of pregnancy require further clarification.

      The main idea for developing this research came from the clinical experience with the use of
      captopril in Obstetric ICU IMIP. This drug has long been used in postpartum women with severe
      preeclampsia or chronic hypertension exacerbated by pregnancy for control of hypertensive
      crisis and keeping pressure levels. Following the technical standards of the institution and
      during his administration, there were reports of side effects such as dry cough and nausea,
      beyond the threshold dose of 150mg daily captopril was easily achieved hindering control the
      use of hypotensive.

      Alternative therapy, clonidine began to be used in mothers with some restriction on the use
      of ACE inhibitors and its hypotensive effect for peak pressure was satisfactory. What is not
      known yet is how long clonidine reduces high blood pressure and how long to leave stabilized
      compared to the use of captopril.

      There are no reports in the literature databases, no randomized clinical trials that prove
      the effectiveness of clonidine for the treatment of hypotensive pressure peaks in this
      particular group of patients, even in comparison with other classes of antihypertensive
      drugs, especially captopril, to this purpose.

      The investigators' primary assumption is that clonidine has better effectiveness in
      decreasing the frequency of pressure peaks when compared with captopril.

      A triple blind randomized clinical trial will be conducted. Postpartum women with
      hypertensive disorders of pregnancy, admitted to the obstetric ICU of IMIP will be included
      in the research. After inclusion in the study, drugs for for very high blood pressure,
      according to randomization(captopril and clonidine)will be used. clonidine and captopril are
      administered at a dose of 25mg and 0.1mg respectively. If there is no control of blood
      pressure in 20 minutes new hypotensive doses will be administered until a total of 150mg/day
      (six tablets) and Captopril 0.6 mg / day (six tablets) clonidine. After exceeded the allowed
      dose, other drugs may be associated. Initially, nifedipine (30mg/day to 60mg/day) according
      to the service routine. The goal of intervention is to maintain a systolic blood pressure
      below 170mmHg and diastolic pressure below 110mmHg, with the lowest possible dose. Thus,
      these medications will be increased should the need arise, according to measurements taken
      daily by the attending physician and the nursing staff.
    

Intervention name(s): CLONIDINE; CAPTOPRIL
Intervention type(s): Drug; Drug
Intervention description(s): Postpartum patients with very high blood pressure will be treated with oral clonidine (0,1mg); Postpartum patients with very high blood pressure will be treated with oral captopril (25mg)
Other intervention name(s): CLON; CAP
Intervention MeSH terms: Clonidine; Captopril
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary purpose: Treatment
Keywords: captopril, clonidine, pregnancy-induced hypertension,