| Title: |
The 'Preeclampsia and Hypertension Target Treatment' ('PYTT') study: a multicenter prospective study to evaluate the effectiveness of the antihypertensive therapy based on maternal hemodynamic findings |
| Authors: |
Pasquo, E; Giannubilo, S; Valentini, B; Salvi, S; Rullo, R; Fruci, S; Filippi, E; Ornaghi, S; Zullino, S; Rossi, F; Farsetti, D; Martino, D; Vasapollo, B; Locatelli, A; De Santis, M; Ciavattini, A; Lanzone, A; Mecacci, F; Ferrazzi, E; Valensise, H; Ghi, T; Pasquo, Elvira di; Giannubilo, Stefano Raffaele; Valentini, Beatrice; Salvi, Silvia; Rullo, Roberta; Fruci, Stefano; Filippi, Elisa; Ornaghi, Sara; Zullino, Sara; Rossi, Francesca; Farsetti, Daniele; Martino, Daniela Denis Di; Vasapollo, Barbara; Locatelli, Anna; De Santis, Michela; Ciavattini, Andrea; Lanzone, Antonio; Mecacci, Federico; Ferrazzi, Enrico; Valensise, Hebert; Ghi, Tullio |
| Publisher Information: |
Elsevier BV country:NL 2024 |
| Document Type: |
Electronic Resource |
| Abstract: |
BACKGROUND: Despite major advances in the pharmacologic treatment of hypertension in the nonpregnant population, treatments for hypertension in pregnancy have remained largely unchanged over the years. There is recent evidence that a more adequate control of maternal blood pressure is achieved when the first given antihypertensive drug is able to correct the underlying hemodynamic disorder of the mother besides normalizing the blood pressure values. OBJECTIVE: This study aimed to compare the blood pressure control in women receiving an appropriate or inappropriate antihypertensive therapy following the baseline hemodynamic findings. STUDY DESIGN: This was a prospective multicenter study that included a population of women with de novo diagnosis of hypertensive disorders of pregnancy. A noninvasive assessment of the following maternal parameters was performed on hospital admission via Ultrasound Cardiac Output Monitor before any antihypertensive therapy was given: cardiac output, heart rate, systemic vascular resistance, and stroke volume. The clinician who prescribed the antihypertensive therapy was blinded to the hemodynamic evaluation and used as first-line treatment a vasodilator (nifedipine or alpha methyldopa) or a beta-blocker (labetalol) based on his preferences or on the local protocols. The first-line pharmacologic treatment was retrospectively considered hemodynamically appropriate in either of the following circumstances: (1) women with a hypodynamic profile (defined as low cardiac output [≤5 L/min] and/or high systemic vascular resistance [≥1300 dynes/second/cm2]) who were administered oral nifedipine or alpha methyldopa and (2) women with a hyperdynamic profile (defined as normal or high cardiac output [>5 L/min] and/or low systemic vascular resistances [ |
| Index Terms: |
hemodynamic; hypertension; pregnancy; therapy; info:eu-repo/semantics/article |
| URL: |
https://hdl.handle.net/10281/470705; info:eu-repo/semantics/altIdentifier/pmid/38574856; info:eu-repo/semantics/altIdentifier/wos/WOS:001302480500001; volume:6; issue:5 (May 2024); journal:AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY, MATERNAL-FETAL MEDICINE |
| Availability: |
Open access content. Open access content; info:eu-repo/semantics/openAccess; license:Creative Commons; license uri:http://creativecommons.org/licenses/by-nc-nd/4.0 |
| Note: |
STAMPA; English |
| Other Numbers: |
ITBAO oai:boa.unimib.it:10281/470705; 10.1016/j.ajogmf.2024.101368; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85190774909; 1434548833 |
| Contributing Source: |
BICOCCA OPEN ARCH; From OAIster®, provided by the OCLC Cooperative. |
| Accession Number: |
edsoai.on1434548833 |
| Database: |
OAIster |