Cannon CM, Levy P, Baumann BM, et al. BMJ Open 2013;3:e002338. doi:10.1136/bmjopen-2012-002338
ARTICLE SUMMARY:
Article focus
▪ "There has been a lack of clinical trial data specific to the management of patients with acute hypertension in the emergency department (ED) and clinicians have had little evidence-based guidance as to the optimal agent for blood pressure (BP) control.
▪ Hypertensive individuals with suspected end-organ damage (EOD) may have different treatment responses than those without.
▪ Our objective was to compare the efficacy of nicardipine versus labetalol for the management of hypertensive patients with signs and/or symptoms (S/S) suggestive of EOD.
Article focus
▪ "There has been a lack of clinical trial data specific to the management of patients with acute hypertension in the emergency department (ED) and clinicians have had little evidence-based guidance as to the optimal agent for blood pressure (BP) control.
▪ Hypertensive individuals with suspected end-organ damage (EOD) may have different treatment responses than those without.
▪ Our objective was to compare the efficacy of nicardipine versus labetalol for the management of hypertensive patients with signs and/or symptoms (S/S) suggestive of EOD.
Key messages
▪ Hypertensive emergencies require immediate, controlled BP reduction to avoid or limit EOD.
▪ Hypertensive ED patients with S/S of EOD treated with nicardipine more often reached the target systolic BP range (TR) than those receiving labetalol (91.4 vs 76.1%).
▪ Patients treated with nicardipine were 3.7 times more likely to be in the TR within 30 min than those treated with labetalol."
▪ Hypertensive emergencies require immediate, controlled BP reduction to avoid or limit EOD.
▪ Hypertensive ED patients with S/S of EOD treated with nicardipine more often reached the target systolic BP range (TR) than those receiving labetalol (91.4 vs 76.1%).
▪ Patients treated with nicardipine were 3.7 times more likely to be in the TR within 30 min than those treated with labetalol."