title: Clevidipine for acute hypertension in patients with subarachnoid hemorrhage: a pilot study.
abstract: OBJECTIVE
  Clevidipine is a novel, ultra-short acting dihydropyridine. We hypothesized that clevidipine would rapidly control elevated blood pressure (BP) in patients with aneurysmal subarachnoid hemorrhage (SAH).
  
  
  METHODS
  This prospective open-label pilot study evaluated the efficacy and safety of clevidipine in reducing blood pressure (BP) to a pre-specified range and within 30 min before or after clipping or coiling of the aneurysm.
  
  
  RESULTS
  We enrolled five patients who received eight clevidipine infusions, including 1587 systolic or diastolic BP data points. The mean SBP upper and lower goals were set at 154 and 122 mmHg. The primary end point of achieving SBP control within <30 min was reached in all patients within 14.2 ± 6.4 min at an infusion rate of 10.8 ± 9.1 mg/h. The mean pre-infusion, during infusion and post-infusion SBP measurements were 165.5 ± 2.55, 146.4 ± 2.48 and 159.3 ± 11.5 mmHg ( p < 0.05 for pre- vs infusion comparison), respectively. After reaching the primary end point and during the clevidipine infusion, 17.5% and 11.8% of SBP readings were above the upper and below the lower goals, respectively. No patients re-bled. In one patient, the infusion had to be stopped temporarily three times due to SBP decrease below the lower goal.
  
  
  CONCLUSIONS
  Clevidipine controlled SBP in all patients with aneurysmal SAH in <22 min and kept it within the elective range 70% of the time without major complications.
authors.affiliation: Departments of Neurology1, Neurosurgery2 and Public Health Sciences3, Henry Ford Hospital , Detroit, Michigan , USA.
authors.forename: Panayiotis N
authors.initials: PN
authors.lastname: Varelas
authors.forename: Tamer
authors.initials: T
authors.lastname: Abdelhak
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Corry
authors.forename: Elysia
authors.initials: E
authors.lastname: James
authors.forename: Mohammed F
authors.initials: MF
authors.lastname: Rehman
authors.forename: Lonni
authors.initials: L
authors.lastname: Schultz
authors.forename: Kathleen
authors.initials: K
authors.lastname: Mays-Wilson
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Mitsias
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D005260:Female; D015600:Glasgow Coma Scale; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011725:Pyridines / Q000627:therapeutic use*; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D055815:Young Adult
chemical_list: D002121:Calcium Channel Blockers; D011725:Pyridines; C118563:clevidipine