Volume : 13, Issue : 05, May – 2026
Title:
HYPODYNAMIC HYPERTENSION IN PREGNANCY:ROLE OF THE CLINICAL PHARMACIST IN A GYNECOLOGICAL WARD-REVIEW ARTICLE
Authors :
Saba mubeena*, Supriya Kulkarni, E. Sreeja, P. Swathi, Dr. P. Soma Sekhar
Abstract :
Background: Hypertensive disorders of pregnancy (HDP) remain a leading contributor to global maternal and perinatal morbidity. Among the hemodynamic subtypes, hypodynamic hypertension — defined by elevated total peripheral vascular resistance (TPVR), low cardiac output (CO), and reduced plasma volume — represents a particularly high-risk phenotype frequently associated with early-onset preeclampsia and fetal growth restriction (FGR). Despite growing evidence that hemodynamic profiling can guide rational pharmacotherapy, this approach remains underimplemented in most clinical settings.
Literature Review: A comprehensive narrative review of peer-reviewed literature published after 2020 was conducted using PubMed, ScienceDirect, and Google Scholar databases. Search terms included ‘hypodynamic hypertension,’ ‘hemodynamics-guided therapy pregnancy,’ ‘clinical pharmacist hypertension pregnancy,’ and related MeSH terms.
Results: Hypodynamic hypertension is characterised by concentric left ventricular (LV) remodeling, high TPVR, and low CO/stroke volume. The landmark multicenter PHTT study (2024) and the systematic review by Kluge et al. (2024-2026) demonstrated that antihypertensive therapy tailored to the hemodynamic phenotype — preferring dihydropyridine calcium channel blockers and nitric oxide donors over beta-blockers in hypodynamic states — significantly improved blood pressure control and reduced severe hypertension events. Clinical pharmacists are uniquely positioned to participate in hemodynamic-guided medication selection, therapeutic drug monitoring, patient education, medication reconciliation, and adverse drug reaction (ADR) surveillance.
Conclusion: Hemodynamic-guided pharmacotherapy represents an evidence-based paradigm shift for managing hypodynamic hypertension in pregnancy. Integration of clinical pharmacists into multidisciplinary obstetric teams — particularly within government hospital settings such as ESI Hospital — can optimise therapeutic outcomes, enhance medication safety, and reduce maternal-fetal complications. Strengthening pharmacist competencies in obstetric cardiovascular pharmacology is critical for the PharmD curriculum.
Keywords: Hypodynamic hypertension; Hypertensive disorders of pregnancy; Hemodynamic-guided therapy; Cardiac output; Total peripheral vascular resistance; Clinical pharmacist; Preeclampsia; Fetal growth restriction; Nifedipine; Labetalol; Antihypertensive therapy; Medication reconciliation; PharmD; ESI Hospital
Cite This Article:
Please cite this article in press Saba Mubeena et al., Hypodynamic hypertension in pregnancy:Role of the clinical pharmacist in a gynecological ward-review article, Indo Am. J. P. Sci, 2026; 13(05).
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