{"id":"ddc4f35228dc","type":"article","url":"https://hartvaat.nl/2017/11/01/labetalol-versus-nifedipine-bij-chronische-hypertensie-in-de-zwangerschap-gerand/","title":"Labetalol versus nifedipine bij chronische hypertensie in de zwangerschap: gerandomiseerde trial","title_en":"Labetalol Versus Nifedipine as Antihypertensive Treatment for Chronic Hypertension in Pregnancy: A Randomized Controlled Trial.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts"],"tags":[],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.117.09972","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.117.09972","authors":["Louise M Webster","Jenny E Myers","Catherine Nelson-Piercy","Kate Harding","J Kennedy Cruickshank","Ingrid Watt-Coote","Asma Khalil","Cornelia Wiesender","Paul T Seed","Lucy C Chappell"],"significance":7,"published":"2017-11-01","source_date":"2017-11-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-zwangerschap/","https://hartvaat.nl/kennis/hypertensie/centrale-middelen-hypertensie/"],"congress":"","summary_en":"This randomized trial comparing labetalol with nifedipine for chronic hypertension in pregnancy provided head-to-head comparative data on the two most commonly used antihypertensive agents in this population, informing drug selection during pregnancy.","created":"2026-07-03T10:26:58Z","updated":"2026-07-03T13:26:15Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Gerandomiseerde trial die labetalol vergeleek met nifedipine bij chronische hypertensie in de zwangerschap. Head-to-head vergelijking van de twee meest gebruikte middelen.","abstract_original":"UNLABELLED: Data from randomized controlled trials to guide antihypertensive agent choice for chronic hypertension in pregnancy are limited; this study aimed to compare labetalol and nifedipine, additionally assessing the impact of ethnicity on treatment efficacy. Pregnant women with chronic hypertension (12+0-27+6 weeks' gestation) were enrolled at 4 UK centers (August 2014 to October 2015). Open-label first-line antihypertensive treatment was randomly assigned: labetalol- (200-1800 mg/d) or nifedipine-modified release (20-80 mg/d). Analysis included 112 women (98%) who completed the study (labetalol n=55, nifedipine n=57). Maximum blood pressure after randomization was 161/101 mm Hg with labetalol versus 163/105 mm Hg with nifedipine (mean difference systolic: 1.2 mm Hg [-4.9 to 7.2 mm Hg], diastolic: 3.3 mm Hg [-0.6 to 7.3 mm Hg]). Mean blood pressure was 134/84 mm Hg with labetalol and 134/85 mm Hg with nifedipine (mean difference systolic: 0.3 mm Hg [-2.8 to 3.4 mm Hg], and diastolic: -1.9 mm Hg [-4.1 to 0.3 mm Hg]). Nifedipine use was associated with a 7.4-mm Hg reduction (-14.4 to -0.4 mm Hg) in central aortic pressure, measured by pulse wave analysis. No difference in treatment effect was observed in black women (n=63), but a mean 4 mm Hg reduction (-6.6 to -0.8 mm Hg; P=0.015) in brachial diastolic blood pressure was observed with labetalol compared with nifedipine in non-black women (n=49). Labetalol and nifedipine control mean blood pressure to target in pregnant women with chronic hypertension. This study provides support for a larger definitive trial scrutinizing the benefits and side effects of first-line antihypertensive treatment. CLINICAL TRIAL REGISTRATION: URL: https://www.isrctn.com. Unique identifier: ISRCTN40973936."}