Which class of blood pressure medications is contraindicated in pregnancy?

The recommendation against using ACE inhibitors and angiotensin receptor blockers (ARBs) during pregnancy is based on substantial evidence showing that these classes of medications can have harmful effects on the developing fetus. Specifically, they can cause teratogenic effects, particularly during the second and third trimesters, leading to serious complications such as renal impairment, oligohydramnios (decreased amniotic fluid), and fetal hypotension.

Research indicates that exposure to ACE inhibitors and ARBs can result in an array of birth defects, particularly affecting the cardiovascular and renal systems of the fetus. As a result, alternative antihypertensive medications that are considered safer during pregnancy, such as methyldopa and labetalol, are recommended instead.

While other classes of antihypertensive medications, like beta-blockers, calcium channel blockers, and diuretics, can be used with caution during pregnancy, ACE inhibitors and ARBs are strongly contraindicated due to their associated risks. This underscores the importance of understanding the safe management of hypertension in pregnant patients to protect maternal and fetal health.