6 VIEWS & REVIEWS

Antihypertensive therapy in women of child-bearing age

The use of ACE inhibitors and ganglionic blockers should be avoided in women of child-bearing age who have hypertension, as these agents cause irreversible renal failure in the infant and meconium ileus in the fetus, say Drs Holly L Casele and Steven A Laifer from the University of Pittsburgh School of Medicine, US.! Their comment is in response to a recent article emphasising the need to tailor antihypertensive therapy to the individual. *

Drs Casele and Laifer note that many women do not plan their pregnancies, and thus, women of child­bearing age who have hypertension should be placed on drugs that are known to be 'safe', in pregnancy. Such agents include methyldopa and hydralazine; calcium antagonists appear to be 'safe' but have been studied less extensively than these other 2 agents. ~-Blockers may have some undesirable adverse effects in pregnancy, and diuretics are generally avoided also, according to Drs Casele and Laifer.

Dr Norman Kaplan from the University of Texas Southwestern Medical Center, Dallas, US, notes that hypertension is relatively uncommon in women of child­bearing age, but agrees that ACE inhibitors, and angio­tensin-IT antagonists, should not be used in such women.2

* See lnphmma 1039: 3, 1 J/m1996; 800431116 1. Casele m.., et al. Oloice of antihypertensive therapy during pregnancy. Journal of the American Medical Association 276: 780, 11 Sep 1996 2. Kaplan N. Oloice of antihypertensive therapy during pregnancy. Reply. Journal of the American Medical Association 276: 780, 11 Sep 1996 800458133

Inphanna" 21 Sep 1996 No. 1055 0156-270319611055-00061$01.00° Ad!s International Limited 1996. All rights reserved