NICARDIPINE VERSUS METOPROLOL IN THE TREATMENT OF HYPERTENSION DURINGPREGNANCY - A RANDOMIZED COMPARATIVE TRIAL

Objective: To compare the effects of treatment with nicardipine and me toprolol in patients with hypertension during pregnancy. Methods: One hundred pregnant patients with mild or moderate hypertension followed at the Centre Hospitalier Intercommunal de Creteil (France) were rando mly allocated to treatment with either nicardipine or metoprolol. Chan ges in maternal blood pressure (BP), laboratory indices, umbilical Dop pler velocimetry, and neonatal outcome were compared by means of Stude nt t test, chi(2) test, and analysis of variance. Results: Nicardipine decreased maternal systolic and diastolic BP more than metoprolol (P <.001). Umbilical artery resistance was lower in nicardipine-treated p atients (P < .001). Plasma uric acid and creatinine concentrations wer e 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 diff erence in neonatal outcome. Conclusion: Nicardipine is more effective than metoprolol in decreasing maternal BP; neonatal outcome is not sig nificantly different.