Background

Hypertensive disorders of pregnancy are associated with mortality and morbidity in offspring and mothers. Use of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs) is contra indicated in pregnancy. The aim was to describe utilization of ACEi and ARBs in pregnancies with hypertensive disorders of pregnancy.

Methods

• Nationwide cross-sectional study
• Data from the Danish registries linked on an individual level
• Population of all pregnancies ending at ≥22 gestational weeks as a live or still birth in 1997-2016
• ACEi and ARBs dispensings during pregnancy Frequencies are rounded to nearest 5

Results

• We included 1,218,633 pregnancies
• 73,960 (6.1%) have been diagnosed with hypertensive disorders of pregnancy
• 19.3% (14,250/73,960) of pregnancies with hypertensive disorders had at least one dispensing of any antihypertensive therapy
• At least one dispensing of ACEi or ARBs in 1% (735/73,960) of pregnancies with hypertensive disorders received at least one dispensing of ACEi or ARBs
• ACEi or ARBs dispensings were rare
• We observed fewer ACEi or ARBs users in later pregnancy (N=695 in first trimester vs. N=50 in second trimester vs. N=25 in third trimester)

Conclusion

As expected the utilization of ACEi or ARBs for therapy of hypertensive disorders of pregnancy was low, but not absent.