Postpartum Evaluation of Antihypertensive Cessation and Efficacy (PEACE): A Randomized Controlled Trial Comparing Oral Labetalol and Oral Extended-Release Nifedipine for Managing Postpartum Hypertension
University of California, Los Angeles
Summary
This randomized controlled trial compares two common medications, labetalol and extended-release nifedipine, to determine which is more effective at managing postpartum high blood pressure. We hypothesize that extended-release nifedipine will better control blood pressure and reduce the need for continued medication beyond six weeks postpartum. The study will enroll 110 postpartum participants, randomly assigning them to one of the two medications, with remote blood pressure monitoring to evaluate treatment effectiveness and inform postpartum hypertension management.
Description
Hypertensive disorders complicate approximately 10% of pregnancies in the United States and are among the leading causes of maternal morbidity and mortality worldwide. These conditions often emerge or persist after delivery, leading to postpartum hypertension. Postpartum hypertension has been associated with the development of chronic hypertension and other cardiovascular concerns, as well as risk of severe complications such as stroke and seizure, and represents a substantial reason for hospital readmission. While oral labetalol and oral extended-release nifedipine are the most commonly presc…
Eligibility
- Age range
- 18–64 years
- Sex
- Female
- Healthy volunteers
- No
Inclusion criteria: Age ≥18 years Delivery at study institution at ≥28 weeks gestation Postpartum SBP \> 150 and/or DBP \> 100 OR 2 or more SBP \> 140 and/or DBP \> 90 within a 24-hour period Require initiation of an oral antihypertensive medication during postpartum hospital stay or within 7 days of discharge Treating obstetric team amenable to starting either study medication Exclusion criteria: Treated with oral antihypertensive medications prior to delivery Known allergies or contraindications to nifedipine or labetalol History of moderate persistent to severe asthma, chronic obstructiv…
Interventions
- DrugLabetalol
Labetalol is a beta-blocker commonly used to manage hypertension in pregnancy and postpartum. In this study, oral labetalol will be initiated at 200mg twice or three times daily and adjusted up to 2400 mg/day as needed for blood pressure control.
- DrugNifedipine
Nifedipine is a calcium channel blocker commonly used to manage hypertension in pregnancy and postpartum. In this study, oral extended-release nifedipine will be initiated at 30mg once daily and adjusted up to 120mg/day as needed for blood pressure control.
Location
- UCLA Ronald ReaganLos Angeles, California