Hypertension cause of birth defects, not drugs

BIRTH defects previously linked to the use of ACE inhibitors early in pregnancy may be due to hypertension itself rather than the drugs treating it, researchers say.

In a population based retrospective cohort study, US researchers examined ACE inhibitor exposure in the first trimester among 465,754 mother-infant pairs in the Kaiser Permanente Northern California region from 1995 to 2008.

Maternal exposure to ACE inhibitors during the first trimester was associated with a 54% increased risk of congenital heart defects, but the use of other antihypertensive drugs was associated with a similar increased risk (52%), they found.

Untreated hypertension was associated with a 41% increased risk of heart defects and an increased risk of neural tube defects.

Researchers concluded that the apparent increased risk of malformation associated with ACE inhibitors and other antihypertensives in the first trimester was likely due to underlying

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