What is the recommended antihypertensive treatment for postnatal women?
The committee recommended the use of an angiotensin converting enzyme (ACE) inhibitor as first-line treatment, except in women of African or Caribbean family origin, in whom a calcium-channel blocker would be used first line. The choice of second-line medicine was modified from the NICE guideline on hypertension in adults as angiotensin receptor blockers, thiazide and thiazide-like diuretics are not recommended during breastfeeding. Therefore the committee agreed that beta-blockers should be used as the second-line antihypertensive agent. The committee also agreed that the medicines with once-daily administration should be used wherever possible and for this reason the committee recommended enalapril in preference to captopril (which is taken 3 times daily) and atenolol as an alternative to labetalol (which is taken 2 to 4 times daily).