Comparing Nifedipine and Enalapril in Medical Resources Used in the Postpartum Period

Brigham and Women's Hospital94 enrolled

Overview

This study evaluates whether nifedipine or enalapril is better at decreasing the amount of medical resources used in the postpartum period by women who have high blood pressure in pregnancy and the postpartum period. Half of participants will receive enalapril while the other half will receive enalapril. We will compare the two groups in the amount of medical resources used which we are defining as prolonged hospitalizations, unscheduled medical visits and/or hospital readmissions in the postpartum period.

This is randomized controlled trial to investigate if enalapril is superior to nifedipine in terms of medical resources used in postpartum women with hypertension. These are both antihypertensives we commonly use in the postpartum period for women with hypertension in pregnancy but we do not know which medication works better at decreasing prolonged hospitalizations, the number of unscheduled medical visits and/or readmissions to the hospital. Nifedipine is more traditionally used and well-validated by current medical literature. However, enalapril's mechanism of action is better suited to the dysregulation of blood pressure that can occur with hypertensive disorders of pregnancy. Therefore, we hypothesize that enalapril is superior to nifedipine in terms of medical resources used in the postpartum period.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Hypertension in Pregnancy

Eligibility

Sex: FEMALEMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * diagnosis of any hypertensive disorder of pregnancy/postpartum period or chronic hypertension * provider wanting to initiate antihypertensive in the postpartum period * the patient is not currently on \>1 antihypertensive * plans to receive postpartum care at the hospital or affiliated clinic Exclusion Criteria: * sustained pulse \<60 or \>120 BPM over four hours * allergy to any of the antihypertensives * creatinine greater than or equal to 1.5 * strict contraindication to any of the antihypertensives * history of failed treatment with any of the antihypertensives

Outcomes

Primary Outcomes

Prolonged Hospitalization

Participants who have any postpartum hospitalization that extends beyond the normal length of stay after delivery