title: Adverse events associated with aggressive treatment of increased blood pressure.
abstract: Patients with severely increased blood pressure often present to the emergency department. Rapid lowering of blood pressure can precipitate or worsen end organ damage. We report two cases that developed cerebrovascular and cardiovascular adverse events associated with aggressive treatment of increased blood pressure by the use of sublingual nifedipine capsule. The first patient had developed ischaemic stroke; the second patient actually had acute left ventricular failure causing deteriorated, and required positive inotropic treatment for persistent hypotension. These cases emphasise that the pseudoemergency may rapidly progress into a real emergency when blood pressure is rapidly and aggressively reduced.
authors.affiliation: Dokuz Eylul University Hospital, Department of Emergency Medicine, Izmir, Turkey. sedat.yanturali@deu.edu.tr
authors.forename: S
authors.initials: S
authors.lastname: Yanturali
authors.forename: S
authors.initials: S
authors.lastname: Akay
authors.forename: C
authors.initials: C
authors.lastname: Ayrik
authors.forename: A A
authors.initials: AA
authors.lastname: Cevik
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000139:chemically induced*; D002214:Capsules; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D009543:Nifedipine / Q000008:administration & dosage / Q000009:adverse effects*; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects*; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced*
chemical_list: D002214:Capsules; D014665:Vasodilator Agents; D009543:Nifedipine