Biomedical subjects
Publications and source records attributed to A J Cha.
Approximately 14% of women of age 20-54 years old have hypertension. For those women who are on medication for hypertension and are pregnant, this poses potential problems. In many cases, antihypertensive agents may be continued in women with chronic hypertension if taken prior to pregnancy. This article discusses the antihypertensive class, calcium channel antagonists, with regard to their physiochemical properties and lactation.
Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are commonly used for the treatment of hypertension. ACEIs have been promoted as first-line therapy for selected patients with chronic hypertension and for the prevention of diabetic nephropathy, thus creating the potential for frequent ACEI exposure among women of childbearing age. ARBs are the most recent addition to the available options for antihypertensive agents. This review specifically focuses on the most up-to-date information regarding these newer antihypertensives with regard to lactation.
Beta-adrenergic antagonists are one of the most commonly used class of agents in the treatment of hypertension. They have also demonstrated utility in the treatment of angina pectoris and certain arrhythmias and for the reduction in mortality following a myocardial infarction. The use of this class of agents creates the potential for beta-blocker exposure among lactating women. This review focuses on the most up-to-date data regarding the more common agents--metoprolol, atenolol, propranolol, carvedilol, nadolol, sotalol, and betaxolol--and their safety in lactating women.
Understanding of the role, triggers, and impact of the renin-angiotensin-aldosterone system in cardiovascular disease has significantly broadened. In recent years substantial discoveries have been made regarding the pathophysiology of heart failure, particularly in the area of neurohormonal activation. New interest in therapy with aldosterone antagonists was stimulated by results of a 2-year study of 1663 patients with heart failure that showed a 30% relative risk reduction of death among patients given a subhemodynamic dosage of spironolactone, a nonselective aldosterone antagonist, compared with placebo, in addition to standard therapy of diuretics, angiotensin-converting enzyme inhibitors, beta-blockers, and digitalis.