A previously feared link between ACE inhibitors (a common treatment for high blood pressure) and congenital heart defects may actually be unfounded, a recent study suggests.
An earlier study, published in the New England Journal of Medicine in 2006, suggested that use of ACE (angiotensin converting enzyme) inhibitors in the first trimester of pregnancy may raise the risk that the child will have a congenital heart or neural tube defect. To assess the validity of these results, researchers performed further assessments of the validity of this link.
The new study, published in the British journal BMJ, analyzed over 460,000 mother-infant pairs. There was no significant difference found in the rate of congenital heart or neural tube defects between mothers with hypertension not using antihypertensives and those using ACE inhibitors or other blood pressure drugs. Based on these results, the study s authors suggest that a mother s high blood pressure may actually be the cause behind any increased risk of birth defects, rather than the antihypertensive drugs themselves.
Considering that many pregnancies are unplanned, women may end up continuing to take these drugs for several weeks before the pregnancy is detected. The results of this study should reduce concern for women who are taking ACE inhibitors when they become pregnant, as well as for those who would otherwise decline such treatment out of fear of harming a future pregnancy. Although it is still not recommended that women take ACE inhibitors during the second and third trimesters, it appears that women may continue using these drugs during the first trimester without any increased risk. A commentary published along with the study explains that the greater concern is that the underling hypertension itself places the fetus at risk.