Efficacy and Safety of Intravenous Urapidil for Older Hypertensive Patients with Acute Heart Failure: A Multicenter Randomized Controlled Trial

Abstract

PurposeUrapidil is putatively effective for patients with hypertension and acute heart failure, although randomized controlled trials thereon are lacking. We investigated the efficacy and safety of intravenous urapidil relative to that of nitroglycerin in older patients with hypertension and heart failure in a randomized controlled trial.Materials and MethodsPatients (>60 y) with hypertension and heart failure were randomly assigned to receive intravenous urapidil (n=89) or nitroglycerin (n=91) for 7 days. Hemodynamic parameters, cardiac function, and safety outcomes were compared.ResultsPatients in the urapidil group had significantly lower mean systolic blood pressure (110.1±6.5 mm Hg) than those given nitroglycerin (126.4±8.1 mm Hg, p=0.022), without changes in heart rate. Urapidil was associated with improved cardiac function as reflected by lower N terminal-pro B type natriuretic peptide after 7 days (3311.4±546.1 ng/mL vs. 4879.1±325.7 ng/mL, p=0.027) and improved left ventricular ejection fraction (62.2±3.4% vs. 51.0±2.4%, p=0.032). Patients given urapidil had fewer associated adverse events, specifically headache (p=0.025) and tachycardia (p=0.004). The one-month rehospitalization and all-cause mortality rates were similar.ConclusionIntravenous administration of urapidil, compared with nitroglycerin, was associated with better control of blood pressure and preserved cardiac function, as well as fewer adverse events, for elderly patients with hypertension and acute heart failure.

Urapidil, compared to nitroglycerin, has better clinical safety in the treatment of hypertensive patients with acute heart failure: a meta-analysis

“…The levels of ALT and AST mainly reflected the function of the liver, and the creatinine levels demonstrated the renal function. Both studies provided data on the toxicity of the drugs and reached the same conclusion, namely, the two drugs were similar in terms of safety 23,24. However, through the integrated analysis of the data, we found that urapidil caused less damage to the liver and kidney functions than nitroglycerin.…”

“…In addition, we performed a sensitivity analysis of the data. When we deleted the Yang et al (2017) study,24 the differences in heterogeneity disappeared and the result was not changed (Figure 11).…”

Efficacy of urapidil for the treatment of patients with senile hypertension and acute heart failure

“…Previous studies have reported that urapidil is used for the treatment of patients with SH and AHF. [20–23] However, no systematic review has explored the efficacy and safety of urapidil for treating SH and AHF. Thus, this study will demonstrate that urapidil administration is as effective in patients with SH and AHF.…”

“…Fortunately, urapidil has reported to treat patients with SH and AHF very well. [20–23] However, there is still no systematic study to assess the efficacy and safety in patients with SH and AHF. Therefore, this study will firstly explore the efficacy and safety of urapidil for the management of SH and AHF.…”

Relationship between enteral nutrition and serum levels of inflammatory factors and cardiac function in elderly patients with heart failure

“…Heart failure (HF) is a clinical syndrome characterized by impaired cardiac function due to various cardiovascular diseases and has a mortality of approximately 50%. [ 1 , 2 ] Although progress has been achieved in HF treatment in recent years, the 5-year mortality of patients with HF remains high. HF can be caused by diseases of the endocardium, myocardium, pericardium, heart valves, and vessels or by metabolic disorders.…”