Comparison of intravenous nicardipine and nitroglycerin to control systemic hypertension after coronary artery bypass grafting.
The efficacy of intravenous (i.v.) nicardipine hydrochloride (a calcium antagonist) compared with nitroglycerin, the drug generally used for treatment of hypertension after coronary artery bypass grafting, was tested in 20 postoperative patients. The patients were randomly divided in a nonblinded manner into 2 groups. Baseline characteristics were similar in the 2 groups. Patients in both groups received various oral calcium antagonists. In addition, 1 group was treated with i.v. nitroglycerin. Both drugs were infused at a maximal rate of 30 mg/hour, as needed to maintain systolic blood pressure below 110 mm Hg. If blood pressure increased to more than 120 mm Hg, nitroprusside was administered. Intravenous nicardipine was superior to nitroglycerin in control of hypertension after coronary artery bypass grafting. In patients treated with nicardipine, blood pressure was decreased sooner (mean infusion time 7.7 hours vs 11.9 hours for nitroglycerin), mean systolic blood pressure was reduced (94 vs 108 mm Hg for the nitroglycerin group; p less than 0.05), and no patient required nitroprusside treatment (compared with 3 patients who required this treatment in the nitroglycerin group). There were no differences in heart rate, diastolic pressure, cardiac index and urine flow between the 2 treatment groups. No adverse effects were observed in patients treated with nicardipine.
Vecht
R J
RJ
Human Hospital Wellington, London, England.
Swanson
K T
KT
Nicolaides
E P
EP
Lennox
S C
SC
Gibson
D G
DG
D001026:Coronary Artery Bypass; D004341:Drug Evaluation; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009529:Nicardipine / Q000008:administration & dosage / Q000627:therapeutic use*; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy*
D009529:Nicardipine; D005996:Nitroglycerin