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Background: Hypertensive emergency is an acute blood pressure elevation with possibility of target-organ damage such as heart, brain, kidneys, eyes and lungs. Nicardipine and Nitroprusside are two widely-used intravenous treatment for hypertensive emergency patients. Nicardipine, a dihydropyridine type calcium channel blocker has strong anti-hypertensive activity while Nitroprusside has been used as an arterial and venous vasodilator. Objective: We aim to find a better choice between intravenous Nicardipin and Nitroprusside on hypertensive emergency patients. Method: We performed a comprehensive study that assesses Nicardipine and Nitroprusside outcome in hypertensive emergency patients up to 2008. Results: There were a total of 734 patients from 5 controlled studies. The pooled analyses showed that systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) had similar baseline. Pooled SBP was lower in Nicardipine group (mean difference -2.21 (-4.09, -0.34), p = 0.02; I 2 : 86%, p < 0.0001). This study showed DBP was lower in Nicardipine group (mean difference -2.93 (-4.39, -1.47), p < 0.0001; I 2 : 0%, p = 0.84). Meta-analysis also showed HR was lower in Nicardipine group compared to control group (mean difference -4.11 (-6.52, -1.69), p = 0.0009; I 2 : 0%, p = 0.89). Conclusion: The systematic review and meta-analysis conclusively establishes the preeminence of Nicardipine over Nitroprusside in efficiently elevated blood pressure during hypertensive emergencies.
Maulana et al. (Wed,) studied this question.
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