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Choice of Antihypertensive Therapy During Pregnancy

Holly L. Casele, MD; Steven A. Laifer, MD
JAMA. 1996;276(10):780. doi:10.1001/jama.1996.03540100024014.
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To the Editor.  —In their article, Drs Kaplan and Gifford1 make the point that certain antihypertensive drugs have unique advantages for certain patients and that rigid adherence to the recommendations of the fifth report of the Joint National Committee for the Detection, Evaluation, and Treatment of High Blood Pressure (JNC V) might not optimally serve the interests of all patients. It is our view that additional considerations should be given to women of childbearing age. The possibility of future conception and the safety of specific antihypertensive drugs during pregnancy should be discussed with all women of childbearing age. Because many women do not plan their pregnancies, patients with hypertension may conceive while taking medication that could adversely affect the fetus. It is not uncommon for uninformed patients to abruptly discontinue their antihypertensive medication(s) when pregnancy is discovered because of their concerns about the fetus. Because these patients may thus


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