Verapamil Successfully Controls Severe Postpartum Hypertension According to a preliminary study

Gestational protein uric hypertension can lead to increased risks of cerebrovascular accidents, cardiac and respiratory failure, renal and hepatic decompensation and blood-related abnormalities for the mother. Current management of postpartum hypertension involves the use of potent and toxic drugs and there are limited treatment options. Therefore, a preliminary open study was conducted to determine the efficacy of verapamil in the treatment of 10 women with severe postpartum gestational proteinuric hypertension (diastolic BP of ~ 105mm Hg). All patients received IV verapamil infused initially at a rate of 40 mg/hour and titrated thereafter to achieve a diastolic BP of 80-100mm Hg. Once goal BP was achieved, patients changed to oral prazosin therapy.

30 min after beginning verapamil infusion, mean BP decreased from 192/123 to 133/85 (p < O.01/p < 0.02). The greatest decrease in BP was evident within the first 5 min of infusion and diastolic BP fell to < 100mm Hg in all patients within 15 min. HR did not change significantly over the infusion period. Two patients experienced facial flushing and 1 a worsened headache.

The authors concluded that ' ... the use of Intravenously titrated verapamll Is a safe, rapidly effective and well·tolerated method of treating severe postpartum prote/nuric hypertension'. Belfort MA. Moore PJ South Af"can Medical Journal 74 265·267, 17 Sep 1988 1761

0156-2703/88/100HJ007/0$01.00/0 CI AD/s Press INPHAlWA" 1 Oct 1988 7