Treatment of Hypertensive Urgencies and Emergencies with Nitrendipine, Nifedipine, and Clonidine

Späh, F.; Grosser, K. D.

doi:10.1097/00005344-198806124-00035

Cited by 17 publications

(7 citation statements)

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“…In patients 11,12,14,15,17, and 18, symptoms and signs of end-organ failure clearly improved. Patients 13 and 19 showed no improvement in end-organ failure within 60 min¬ utes.…”

Section: Resultsmentioning

confidence: 94%

Comparison of Sublingual Captopril and Nifedipine in Immediate Treatment of Hypertensive Emergencies

Angeli¹

1991

Arch Intern Med

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“…In patients 11,12,14,15,17, and 18, symptoms and signs of end-organ failure clearly improved. Patients 13 and 19 showed no improvement in end-organ failure within 60 min¬ utes.…”

Section: Resultsmentioning

confidence: 94%

Comparison of Sublingual Captopril and Nifedipine in Immediate Treatment of Hypertensive Emergencies

Angeli¹

1991

Arch Intern Med

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“…[24][25][26][27][28][29][30][31][32][33][34][35] Other trials included patients without explicitly stating whether patients had acute end-organ damage or not (7 trials). [36][37][38][39][40][41][42] Some trials included non-randomized participants in the trial's results (1 trial).…”

Section: Resultsmentioning

confidence: 99%

“…In 19 of the excluded trials [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] it was not possible to determine how many patients had acute endorgan damage or merely had elevation of blood pressure. We believe that it would be misleading to include these trials in this review as the impact of antihypertensive drugs is potentially different.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological interventions for hypertensive emergencies: a Cochrane systematic review

Perez

Musini

2008

J Hum Hypertens

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Hypertensive emergencies occur when high blood pressure is associated with the presence of acute endorgan damage, such as hypertensive encephalopathy. There is controversy as to when and which antihypertensive drugs to use in these situations. Using a comprehensive search strategy in electronic sources, MEDLINE, EMBASE and Cochrane clinical trial register, we conducted a systematic review to look all randomized control trials (RCTs) that compare an antihypertensive drug versus placebo, no treatment or another antihypertensive drug. Fifteen RCTs (representing 869 patients) met the inclusion criteria. Two trials included a placebo arm. All studies (except one) were open-label trials. Seven drug classes were evaluated in those trials: nitrates (nine trials), angiotensin-converting enzyme inhibitors (seven), diuretics (three), calcium channel blockers (six), a-1 adrenergic antagonists (four), direct vasodilators (two) and dopamine agonists (one). Mortality event data were reported in seven trials. Due to insufficient data, no meta-analysis was performed for clinical outcomes. Differences in blood pressure changes between antihypertensives were minor. There is no RCT evidence demonstrating that antihypertensive drugs reduce mortality or morbidity in patients with hypertensive emergencies. Furthermore, there is insufficient RCT evidence to determine which drug or drug class is most effective in reducing mortality and morbidity. There were some minor differences in the degree of blood pressure lowering when one class of antihypertensive drug is compared to another. However, the clinical significance is unknown. RCTs are needed to assess different drug classes to determine initial and longer-term mortality and morbidity outcomes.

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“…Sudden uncontrolled and severe reductions in blood pressure accompanying the administration of nifedipine may precipitate cerebral, renal, and myocardial ischemic events, which have been associated with fatal outcomes [72,108,130-133,137-140]. Elderly hypertensive patients with underlying organ impairment and structural vascular disease are more vulnerable to the rapid and uncontrolled reduction in arterial pressure [138].…”

Section: Pharmacologic Agents Used In the Treatment Of Hypertensive Cmentioning

confidence: 99%

Untitled

2003

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Hypertension is an extremely common clinical problem, affecting approximately 50 million people in the USA and approximately 1 billion individuals worldwide. Approximately 1% of these patients will develop acute elevations in blood pressure at some point in their lifetime. A number of terms have been applied to severe hypertension, including hypertensive crises, emergencies, and urgencies. By definition, acute elevations in blood pressure that are associated with end-organ damage are called hypertensive crises. Immediate reduction in blood pressure is required only in patients with acute endorgan damage. This article reviews current concepts, and common misconceptions and pitfalls in the diagnosis and management of patients with acutely elevated blood pressure.

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Treatment of Hypertensive Urgencies and Emergencies with Nitrendipine, Nifedipine, and Clonidine

Cited by 17 publications

References 0 publications

Comparison of Sublingual Captopril and Nifedipine in Immediate Treatment of Hypertensive Emergencies

Comparison of Sublingual Captopril and Nifedipine in Immediate Treatment of Hypertensive Emergencies

Pharmacological interventions for hypertensive emergencies: a Cochrane systematic review

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