Key result
Rapid BP reduction with nifedipine causes T-wave inversions in ~26% of patients without impairing wall motion.
Why the study?
The significance of T-wave inversion after rapid blood pressure reduction by vasodilators in severe hypertensives without ischemic symptoms was not known.
Does rapid blood pressure reduction with nifedipine cause myocardial ischemia (indicated by wall motion abnormalities) in patients with severe hypertension?
Does rapid blood pressure reduction with nifedipine cause myocardial ischemia (indicated by wall motion abnormalities) in patients with severe hypertension?
Absolute Event Rate: 1.2% vs 1.4%
p-value: p=<.05
Asymptomatic T-wave inversions following rapid blood pressure reduction with nifedipine are not associated with left ventricular wall motion abnormalities, suggesting they do not represent significant myocardial ischemia.
No takes yet. Share an insight, caveat, or question.
May reassure against ischemia from nifedipine T-wave changes; hypothesis-generating and should not yet alter practice.
Phillips et al. (1991) studied Severe hypertension (n=23). Nifedipine vs. Pretreatment baseline was evaluated on Wall motion score (p=<.05). Rapid blood pressure reduction with 10 mg nifedipine caused new T-wave inversions in 26% of patients but no new wall motion abnormalities, with wall motion scores improving from 1.4 to 1.2 (P<.05).
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