ACE inhibitors: New warning for pregnant women

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ACE inhibitors: New warning for pregnant women

ACE inhibitors may increase the risk of birth defects if taken during early pregnancy.

What happened? Women who have high blood pressure and are pregnant or considering pregnancy have a serious new warning when it comes to blood pressure medication.

A common class of blood pressure medications known as angiotensin-converting enzyme (ACE) inhibitors may increase the risk of birth defects if taken during the first three months of pregnancy, suggests a new study published in the New England Journal of Medicine. ACE inhibitors were already known to pose risks for a developing baby if taken during the second or third trimester of pregnancy. But this study is the first to point out the possible dangers of ACE inhibitors taken during the first trimester.

In the study, the risk of major birth defects in children whose mothers took ACE inhibitors during the first trimester was nearly three times higher than in children whose mothers didn't take blood pressure medication. The birth defects ranged from spinal deformations to holes in the chambers of the heart. No increased risk was identified for other blood pressure medications.

The Food and Drug Administration (FDA) has issued an alert to warn women and their doctors about the possible risks of taking ACE inhibitors during early pregnancy. Some examples of ACE inhibitors include lisinopril (Prinivil), benazepril (Lotensin), captopril (Capoten), ramipril (Altace) and trandolapril (Mavik).

What does this mean to you? Up to 5 percent of women have high blood pressure before they become pregnant, according to the American College of Obstetricians and Gynecologists. Sometimes diet and exercise are enough to control high blood pressure. In other cases, medication is needed.

If you have high blood pressure and are considering pregnancy, don't take an ACE inhibitor. It may be best to avoid related classes of medications as well, such as angiotensin II receptor blockers.

If you need medication to control your blood pressure, your doctor will prescribe a safer medication at the lowest effective dose. If you're pregnant and already taking an ACE inhibitor, don't stop taking the medication or adjust the dose on your own. Ask your doctor about other options right away.

Last Updated: 06/09/2006
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