Evaluation of the Efficacy and Safety of Nicardipine Versus Clevidipine for Blood Pressure Control in Hypertensive Crisis

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
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引用次数: 0

Abstract

Background

Hypertensive crisis is an acute increase in blood pressure >180/120 mm Hg. A titratable antihypertensive agent is preferred to lower blood pressure acutely in a controlled way and prevent an abrupt overcorrection. Nicardipine and clevidipine are both dihydropyridine calcium channel blockers that provide unique benefits for blood pressure control.

Objective

The purpose of this study was to compare the efficacy and safety of nicardipine or clevidipine for blood pressure control in the setting of hypertensive crisis.

Methods

This was a single-center, retrospective cohort study. Eligible patients received either nicardipine or clevidipine for the treatment of hypertensive crisis. The primary outcome was achievement of 25% reduction in mean arterial pressure at 1 h. The secondary outcome was achievement of a systolic blood pressure (SBP) of <160 mm Hg at 2–6 h from the start of the infusion.

Results

This study included a total of 156 patients, 74 in the nicardipine group and 82 in the clevidipine group. The SBP on admission and at the start of the infusion were similar between groups. There was no difference between groups in achieving a 25% reduction in mean arterial pressure at 1 h. Nicardipine achieved an SBP goal of <160 mm Hg at 2–6 h significantly more often than the clevidipine group (89.2% vs. 73.2%; p = 0.011).

Conclusions

There is no difference between agents for initial blood pressure control in the treatment of hypertensive crisis. Nicardipine showed more sustained SBP control, with a lower risk of rebound hypertension and a significant cost savings compared with clevidipine.

评估尼卡地平和氯维地平在高血压危象中控制血压的有效性和安全性
背景高血压危象是指血压急剧升高至 180/120 mm Hg。首选可滴定的降压药,以控制血压急性下降,防止血压突然过度纠正。尼卡地平和氯维地平都是二氢吡啶类钙通道阻滞剂,在控制血压方面具有独特的优势。本研究旨在比较尼卡地平和氯维地平在高血压危象情况下控制血压的有效性和安全性。符合条件的患者接受尼卡地平和氯维地平治疗高血压危象。主要结果是 1 小时内平均动脉压降低 25%。次要结果是输液开始后 2-6 小时内收缩压(SBP)达到 160 mm Hg。结果这项研究共纳入 156 名患者,其中尼卡地平组 74 人,氯维地平组 82 人。两组患者入院时和输液开始时的 SBP 相似。结论在治疗高血压危象时,不同药物在初始血压控制方面没有差异。与氯维地平相比,尼卡地平能更持久地控制 SBP,反跳性高血压的风险更低,而且能显著节省费用。
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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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