Assessment of the effect of adding furosemide to antihypertensive treatment on postpartum hypertension in women with preeclampsia; a randomized clinical trial

IF 0.2 Q4 UROLOGY & NEPHROLOGY Journal of Renal Injury Prevention Pub Date : 2022-03-04 DOI:10.34172/jrip.2022.31977
T. Jahed Bozorgan, Pegah Azadi, Zahra Dehghani
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Abstract

Introduction: One of the probable mechanisms of hypertension that may occur in women with preeclampsia after delivery is returning of interstitial and extravascular fluid into the bloodstream. Objectives: The present study aimed to investigate the effect of furosemide to control postpartum hypertension in women with preeclampsia. Patients and Methods: This randomized clinical trial was conducted on 116 patients with preeclampsia with a blood pressure (BP) of more than 150/100 mm Hg in the first 24 hours after delivery. Patients were randomly divided into two groups of nifedipine (taking 10 mg tablets every 8 hours) and nifedipine plus furosemide (nifedipine plus 20 mg furosemide tablet once daily). Patients were monitored until the fifth day after delivery. After the first 48 hours, patients with a BP lower than 150/100 mm Hg were discharged from the hospital and the treatment continued at home. Results: Systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were significantly reduced in all patients and in each group on the first to fifth days after delivery. On the second day, DBP in the nifedipine group was significantly lower (P=0.005). On the third to fifth days, SBP in the nifedipine plus furosemide group was significantly lower (P<0.05), while DBP did not change (P>0.05). On the third and fourth days, MAP was significantly lower in the nifedipine plus furosemide group (P<0.05), however it was not significantly different on the fifth day (P=0.383). The need for additional medication to control BP was higher in the nifedipine group than in the nifedipine plus furosemide group. BP became normal (less than 120/80 mmHg) in 74 patients (68%) within five days after delivery; which was more popular in the nifedipine plus furosemide group (P<0.001). Conclusion: The findings of the present study showed that inclusion of furosemide in nifedipine regimen was associated with a further reduction in SBP and MAP. Furosemide also reduced the need for additional medication to control BP and increased the frequency and speed of reaching toward normal BP. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20191031045289N2; https://irct.ir/trial/49806, ethical code; IR.SBMU.MSP. REC.1399.067).
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速尿联合降压治疗先兆子痫妇女产后高血压的疗效评价;随机临床试验
导言:分娩后子痫前期妇女高血压的可能机制之一是间质和血管外液体回流到血液中。目的:本研究旨在探讨速尿对子痫前期妇女产后高血压的控制作用。患者和方法:本随机临床试验对116例分娩后24小时血压(BP)大于150/100 mm Hg的先兆子痫患者进行了研究。患者随机分为硝苯地平组(每8小时服用10 mg片)和硝苯地平加呋塞米组(硝苯地平加呋塞米片20 mg,每日1次)。监测患者至分娩后第5天。48小时后,血压低于150/100 mm Hg的患者出院,并在家中继续治疗。结果:所有患者及各组在分娩后第1 ~ 5天收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)均显著降低。第2天,硝苯地平组DBP显著降低(P=0.005)。第3 ~ 5天,硝苯地平加呋塞米组收缩压明显降低(P0.05)。硝苯地平加呋塞米组在第3、4天MAP显著降低(P<0.05),第5天差异无统计学意义(P=0.383)。硝苯地平组需要额外的药物来控制血压高于硝苯地平加呋塞米组。74例患者(68%)在分娩后5天内血压恢复正常(低于120/80 mmHg);硝苯地平加呋塞米组更常见(P<0.001)。结论:本研究结果表明,在硝苯地平方案中纳入呋塞米与收缩压和MAP的进一步降低有关。速尿也减少了额外的药物控制血压的需要,并增加了达到正常血压的频率和速度。试验注册:试验方案已获得伊朗临床试验注册中心批准(标识符:IRCT20191031045289N2;https://irct.ir/trial/49806,道德准则;IR.SBMU.MSP。REC.1399.067)。
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来源期刊
Journal of Renal Injury Prevention
Journal of Renal Injury Prevention UROLOGY & NEPHROLOGY-
CiteScore
1.60
自引率
0.00%
发文量
36
期刊介绍: The Journal of Renal Injury Prevention (JRIP) is a quarterly peer-reviewed international journal devoted to the promotion of early diagnosis and prevention of renal diseases. It publishes in March, June, September and December of each year. It has pursued this aim through publishing editorials, original research articles, reviews, mini-reviews, commentaries, letters to the editor, hypothesis, case reports, epidemiology and prevention, news and views and renal biopsy teaching point. In this journal, particular emphasis is given to research, both experimental and clinical, aimed at protection/prevention of renal failure and modalities in the treatment of diabetic nephropathy. A further aim of this journal is to emphasize and strengthen the link between renal pathologists/nephropathologists and nephrologists. In addition, JRIP welcomes basic biomedical as well as pharmaceutical scientific research applied to clinical nephrology. Futuristic conceptual hypothesis that integrate various fields of acute kidney injury and renal tubular cell protection are encouraged to be submitted.
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