title: Isradipine for treatment of acute hypertension after myocardial revascularization.
abstract: OBJECTIVE
  To evaluate the efficacy and duration of action of iv isradipine in the control of postoperative hypertension immediately after myocardial revascularization.
  
  
  METHODS
  Prospective, phase 2 trial.
  
  
  METHODS
  Surgical ICU, university hospital.
  
  
  METHODS
  Twenty-one (15 male, six female) patients, ages 49 to 75 yr (mean 65 +/- 5), undergoing elective myocardial revascularization.
  
  
  METHODS
  Twenty-one patients with postoperative hypertension after coronary artery bypass graft surgery received iv isradipine, a new dihydropyridine calcium-channel antagonist. Mean duration of the isradipine infusion was 96.9 +/- 29 min. Mean dose of isradipine, indexed to weight, was 16.63 +/- 6.66 micrograms/kg (n = 20).
  
  
  RESULTS
  Twenty of the 21 patients achieved satisfactory BP control. The reduction in mean arterial pressure (MAP), first noted at the 15-min point, was maximal at 1 hr when MAP decreased from 102 +/- 9 mm Hg baseline to 81 +/- 5 mm Hg (p less than .01), accompanied by a significant (p less than .01) decrease in systemic vascular resistance from 1753 +/- 339 baseline to 1180 +/- 229 dyne.sec/cm5. The CVP, pulmonary artery diastolic pressure, and pulmonary artery occlusion pressure did not change significantly. Heart rate and cardiac index increased; however, stroke volume index did not change.
  
  
  CONCLUSIONS
  Isradipine is an acceptable agent for the treatment of hypertension in this setting.
authors.affiliation: Department of Anesthesiology, Temple University Health Sciences Center, Philadelphia, PA 19141.
authors.forename: N W
authors.initials: NW
authors.lastname: Brister
authors.forename: R E
authors.initials: RE
authors.lastname: Barnette
authors.forename: S A
authors.initials: SA
authors.lastname: Schartel
authors.forename: J B
authors.initials: JB
authors.lastname: McClurken
authors.forename: J
authors.initials: J
authors.lastname: Alpern
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D001026:Coronary Artery Bypass; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017275:Isradipine; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011183:Postoperative Complications / Q000188:drug therapy*; D011725:Pyridines / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D011725:Pyridines; D017275:Isradipine