We will discuss “Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review” by the Community Level Interventions for Pre-eclampsia (CLIP) Working Group from 27 August 2014 for 7 days.
*This paper has been made open-access by the authors. Its accompanying mini-commentary by ME Norton will be made free-to-view on 18 August 2014.
Start date: 27 August 2014 (the discussion will open for 7 days)
First hosted discussion session(s) starts at: BST 7pm (UK time)
The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of each month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days with an advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper here (data S1).
The discussion points are attached below (quoted from the published manuscript)
|An asymptomatic patient is admitted to the high dependency unit of the labour ward with severe postpartum gestational hypertension. Her blood pressure (BP) is poorly controlled (systolic 168 mmHg/diastolic 112 mmHg). Following a decision concerning her management, she requests oral antihypertensive therapy. She asks: ‘is medication through the drip really better?’|
Description of research
|Participants||Severe hypertension (systolic BP ≥160 mmHg/diastolic BP ≥110 mmHg) in any hypertensive disorder in pregnancy|
|Intervention||Oral antihypertensive therapy|
|Comparison||Antihypertensive therapy (any route), placebo or no treatment|
|Outcomes||Primary outcome: treatment success (achievement of target BP occurring within 24 hour of treatment)Secondary outcomes: Maternal and perinatal outcomes|
|Study design||Systematic review of randomised controlled trials|
- What is the definition of severe hypertension?
- Which study characteristics are assessed when determining the risk of bias of included studies?
- Which secondary outcomes would you consider most important and why?
- What is the significance of the confidence intervals when considering the Forest plots in this study?
- Can you briefly summarise the results of the summary? How would you advise the patient in this clinical situation?
- What are the benefits of oral antihypertensive medication within resource-poor settings? (Data S1)
For those who want to understand hashtags, this may be a useful guide. For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Follow @BlueJCHost, this blog and our Facebook page to receive news about #BlueJC.