title: Therapeutic effects of intravenous urapidil in elderly patients with hypertension and acute decompensated heart failure: A pilot clinical trial.
abstract: Urapidil has been proposed to be an effective vasodilator for the treatment of acute decompensated heart failure (ADHF); however, its effect on cardiac function, as compared with that of nitroglycerin, in elderly patients with hypertension and ADHF has yet to be determined. In the present study, a multicenter, open-label clinical trial was performed, in which 120 elderly patients with hypertension and ADHF were randomly assigned to the treatment (50-400 µg/min intravenous urapidil) or control group (5-40 µg/min intravenous nitroglycerin). The dosages of the medications were adjusted according to the blood pressure of the patients. The systolic and diastolic blood pressure, heart rate and serum level of N-terminal pro B-type natriuretic peptide (NT-proBNP) were evaluated at hospital admission and at days 1, 2, 3 and 7 after treatment. In addition, the left ventricular function was assessed by measuring the left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume at hospital admission and at days 2 and 7 after treatment. The results indicated that intravenous administration of urapidil and nitroglycerin were effective in lowering the blood pressure and heart rate within 7 days, with no significant differences observed between the two groups (P>0.05). By contrast, greater reduction in the serum NT-proBNP level (2,410.4±546.1 vs. 4,234.1±876.4 pg/ml; P<0.05) and greater improvement in the LVEF (55.3±3.4 vs. 45.2±2.4%; P<0.05) were observed in the urapidil-treated group, as compared with the nitroglycerin-treated group. No adverse events were reported during the treatment period in the two groups. The clinical outcomes at 6 months following discharge were evaluated and were not found to be significantly different between the two groups. In conclusion, the present results of the present study suggested that urapidil was as effective as nitroglycerin in controlling blood pressure and heart rate and was more effective in improving cardiac systolic function in elderly patients with hypertension and ADHF.
authors.affiliation: Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing 100053, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Cardiology, An Zhen Hospital Affiliated to Capital Medical University, Beijing 100029, P.R. China.
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Zhou
authors.affiliation: Emergency Department, Tong Ren Hospital Affiliated to Capital Medical University, Beijing 100005, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Cardiology, Xuan Wu Hospital, Capital Medical University, Beijing 100053, P.R. China.
authors.forename: Jian
authors.initials: J
authors.lastname: Qin
authors.affiliation: Department of Cardiology, First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, P.R. China.
authors.forename: Shu
authors.initials: S
authors.lastname: Tan
authors.affiliation: Department of Cardiology, Ningbo First Hospital, Ningbo, Zhejiang 315010, P.R. China.
authors.forename: Xiao-Min
authors.initials: XM
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Luhe Hospital, Affiliated to Capital Medial University, Beijing 101100, P.R. China.
authors.forename: Jin-Cheng
authors.initials: JC
authors.lastname: Guo
authors.affiliation: Department of Cardiology, Mentougou District Hospital of Beijing City, Beijing 102300, P.R. China.
authors.forename: DE-Zhao
authors.initials: DZ
authors.lastname: Wang
authors.affiliation: Emergency Department, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, P.R. China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhan
authors.affiliation: Department of Cardiology, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150030, P.R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Guan
authors.affiliation: Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, P.R. China.
authors.forename: Ya-Wei
authors.initials: YW
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Xuan Wu Hospital, Capital Medical University, Beijing 100053, P.R. China.
authors.forename: Jing-Yu
authors.initials: JY
authors.lastname: He
authors.affiliation: Department of Cardiology, Xuan Wu Hospital, Capital Medical University, Beijing 100053, P.R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Cardiology, Xuan Wu Hospital, Capital Medical University, Beijing 100053, P.R. China.
authors.forename: Q I
authors.initials: QI
authors.lastname: Hua
keywords: acute decompensated heart failure; cardiac function; clinical trial; nitroglycerin; urapidil