Dosing trajectories of antihypertensive agents among preterm neonates: A retrospective, cross-sectional analysis
Year: 2025
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: Preterm infants are at increased risk for hypertension due to incomplete organ development. With no established guidelines for treating hypertension in this population, clinicians rely on their experience, and little is known regarding those treatment decisions. This study described dosing trajectories for the three most common antihypertensive agents in preterm infants. METHODS: This retrospective, cross-sectional study examined preterm neonates (gestational age at birth < 37 weeks, postmenstrual age < 44 weeks) treated with antihypertensive medications at the University of Alabama at Birmingham (UAB) Medical Center. The study identified the three most common antihypertensive agents and identified common dosing patterns over time using the functional K-means algorithm. We then compared demographic and clinical information across these clusters. RESULTS: The study included 87 patients across 93 visits. The three most common antihypertensive agents were propranolol (61%), captopril (8.8%), and esmolol (12%). Median treatment durations were 292 hours for propranolol, 186 hours for captopril, and 68 hours for esmolol. Propranolol was often initiated at a dose that was maintained with few dosing changes. Patients needing higher doses of propranolol were generally younger gestational age and spent longer in the hospital. Captopril doses started low and increased over time, likely due to safety concerns. Esmolol showed the most variable dosing trajectories. CONCLUSIONS: Propranolol is often initiated at a target dose and maintained with less titration, while both captopril and esmolol are titrated more often. Younger gestational age patients typically required higher doses of propranolol.
Source: PLoS ONE
Authors: Mary-Carty Pittman, Alejandro D. Perez, Kaniz Afroz Tanni, Keia R. Sanderson, Jieun Park, Daniel I. Feig, Matthew M. Laughon, Matthew Shane Loop
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
Funders: Gates Ventures, Clinical Trials Fund, Canadian Institutes of Health Research, Merck Healthcare KGaA, Hyogo Science and Technology Association, Howard Hughes Medical Institute, GAVI Alliance, Eli Lilly and Company, Pfizer, UNICEF, Joachim Herz Stiftung, University of Hawai'i, Parkes Foundation, Wellcome Trust, American Society for Investigative Pathology, LifeArc, Natural Science Foundation of Guangxi Zhuang Autonomous Region, UK Research and Innovation, Marshall Aid Commemoration Commission, Elton John AIDS Foundation, Chan Zuckerberg Initiative, Stichting Stoffels-Hornstra, Gesellschaft für Forschungsförderung Niederösterreich, National Institute for Health and Care Research, British Academy, Scottish Funding Council, Academy of Medical Sciences, Rhodes Scholarships, European Commission, Bayer HealthCare, National Research Foundation Singapore, Deutsche Forschungsgemeinschaft, Kurita Water and Environment Foundation, University of Melbourne, National Natural Science Foundation of China, China Postdoctoral Science Foundation, Eusko Jaurlaritza, Fonds Wetenschappelijk Onderzoek, Ministerio de Economía y Competitividad, National Research Foundation of Korea, Natural Science Foundation of Hebei Province, Japan International Cooperation Agency, Ministarstvo Prosvete, Nauke i Tehnološkog Razvoja, Natural Science Foundation of Hunan Province, State Government of Victoria, Belgisch Ontwikkelingsagentschap, Fundo para o Desenvolvimento das Ciências e da Tecnologia, Forskningsrådet om Hälsa, Arbetsliv och Välfärd, Beijing Academy of Agricultural and Forestry Sciences, Qinglan Project of Jiangsu Province of China, Project of Shandong Province Higher Educational Science and Technology Program, Science Fund of the Republic of Serbia, Natural Science Foundation of Sichuan Province, Kenya Medical Research Institute, Nigerian Institute of Medical Research, Aventis Foundation, National Institutes of Health, Michigan Institute for Clinical and Health Research, Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Social Sciences and Humanities Research Council of Canada, Fonds de Recherche du Québec - Santé, Economic and Social Research Council, National Health and Medical Research Council, Japan Society for the Promotion of Science, Japan Science and Technology Agency, Research for Patient Benefit Programme, Agencia Estatal de Investigación, National Key Research and Development Program of China, Fundamental Research Funds for the Central Universities, Key Laboratory of Industrial Internet of Things and Networked Control, Ministry of Education, National Institute for Health Research Applied Research Collaboration South London, National Center for Advancing Translational Sciences, Core Research for Evolutional Science and Technology, Science and Technology Research Partnership for Sustainable Development, HORIZON EUROPE Marie Sklodowska-Curie Actions, HORIZON EUROPE European Innovation Council, Institute of Plant Science and Resources, Okayama University, Health Data Research UK
OpenAlex ID: W4417133820