Nicardipine versus metoprolol in the treatment of hypertension during pregnancy: a randomized comparative trial.

Abstract

To compare the effects of treatment with nicardipine and metoprolol in patients with hypertension during pregnancy. One hundred pregnant patients with mild or moderate hypertension followed at the Centre Hospitalier Intercommunal de Créteil (France) were randomly allocated to treatment with either nicardipine or metoprolol. Changes in maternal blood pressure (BP), laboratory indices, umbilical Doppler velocimetry, and neonatal outcome were compared by means of Student t test, chi 2 test, and analysis of variance. Nicardipine decreased maternal systolic and diastolic BP more than metoprolol (P < .001). Umbilical artery resistance was lower in nicardipine-treated patients (P < .001). Plasma uric acid and creatinine concentrations were increased less markedly in the nicardipine group (P < .05 and P < .01, respectively). The incidence of cesarean delivery for fetal distress was lower in the nicardipine group (P < .01). There was a trend toward higher birth weights in the nicardipine group but no significant difference in neonatal outcome. Nicardipine is more effective than metoprolol in decreasing maternal BP; neonatal outcome is not significantly different.