ANTIHYPERTENSIVE DRUGS AND PREGNANCY

I treat several sexually active women aged 28-40 years who have hypertension but refuse contraception for a variety of reasons. Hydrochlorothiazide alone has not been effective or has not been tolerated. Which antihypertensive medication would you recommend in these circumstances? None of these patients has coexisting illnesses that would influence the choice of agent.
—Sarah J. Norris, ND, APRN, BC, Loris, S.C.

Given that the only antihypertensive drugs contraindicated in pregnancy are the ACE inhibitors and the angiotensin receptor blockers, you still have a number of choices (besides nitroprusside, that is, which isn’t used for outpatient treatment anyway). The calcium channel blockers are safe and effective—as are the beta blockers and methyldopa.
—Reuben W. Zimmerman, PA-C (106-4)