What does this research mean for the field?

Intravenous nicardipine is as effective as sodium nitroprusside for the immediate control of severe hypertension, while requiring significantly fewer dosage adjustments and producing fewer adverse side effects. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To compare the antihypertensive efficacy and safety of intravenous nicardipine with intravenous sodium nitroprusside in patients presenting with severe hypertension.

July 1, 1994American Journal of Hypertension

A Comparison of Intravenous Nicardipine and Sodium Nitroprusside in the Immediate Treatment of Severe Hypertension

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Why the study?

Does intravenous nicardipine improve antihypertensive efficacy and safety compared to sodium nitroprusside in patients with severe hypertension?

Population

121 patients with severe hypertension (diastolic blood pressure > 120 mm Hg, or systolic BP > 200 mm Hg)

Comparison

Intravenous nicardipine administered according… vs Intravenous sodium nitroprusside administered…

Design

RCT, Randomized

Follow-up

10 to 12 hours

Authors

JNJoel M. NeutelOrange County Research Center DSDavid H.G. SmithMayo Clinic in Arizona DWDiana J. WallinDartmouth College

Discussion

Member takes

Implication

Supports nicardipine preference in severe hypertension; confirms RCT advantages in dosing and safety versus SNP.

Key Points

To compare the antihypertensive efficacy and safety of intravenous nicardipine with intravenous sodium nitroprusside in patients presenting with severe hypertension.
Randomized trial conducted in 121 patients with severe hypertension (diastolic blood pressure > 120 mm Hg or systolic blood pressure > 200 mm Hg).
Patients received either intravenous nicardipine (n=61) or intravenous sodium nitroprusside (n=60) for a 10 to 12 hour period following a predetermined dosing schedule.
Therapeutic blood pressure response occurred in 98% (60/61) of nicardipine-treated patients and 93% (56/60) of nitroprusside-treated patients, with 4-hour mean systolic/diastolic reductions of 61/40 mm Hg versus 59/38 mm Hg, respectively.
Nicardipine required significantly fewer dose adjustments per hour to maintain blood pressure reduction than nitroprusside (0.5 ± 0.1 vs 1.5 ± 0.2 adjustments per hour, P < .01).
Significantly fewer nicardipine patients developed drug-related side effects compared to the nitroprusside group (31% vs 56%, P < .05), with early study discontinuation occurring in 1 nicardipine patient versus 10 nitroprusside patients.

Structured PICO

Does intravenous nicardipine improve antihypertensive efficacy and safety compared to sodium nitroprusside in patients with severe hypertension?

Population

121 patients with severe hypertension (diastolic blood pressure > 120 mm Hg, or systolic BP > 200 mm Hg)

Intervention

Intravenous nicardipine administered according to a predetermined dosing schedule for a 10 to 12 h period

Comparator

Intravenous sodium nitroprusside (SNP) administered according to a predetermined dosing schedule for a 10 to 12 h period

Outcome

Antihypertensive efficacy (therapeutic response: diastolic BP < 100 mm Hg, or a decrease of >15 mm Hg; systolic BP < 180 mm Hg, or a decrease of >20 mm Hg) and safetysurrogate

Intravenous nicardipine is as effective as sodium nitroprusside for immediate BP control in severe hypertension, but requires fewer dosage adjustments and has a better safety profile.

Cite This Study

Neutel et al. (1994) studied this question.

synapsesocial.com/papers/6a1c1fc4ea84844e355f7aab https://doi.org/10.1093/ajh/7.7.623

Topics

Hypertension management

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A Comparison of Intravenous Nicardipine and Sodium Nitroprusside in the Immediate Treatment of Severe Hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

A Comparison of Intravenous Nicardipine and Sodium Nitroprusside in the Immediate Treatment of Severe Hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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