title: Efficacy and Safety of Intravenous Urapidil for Older Hypertensive Patients with Acute Heart Failure: A Multicenter Randomized Controlled Trial.
abstract: OBJECTIVE
  Urapidil is putatively effective for patients with hypertension and acute heart failure, although randomized controlled trials thereon are lacking. We investigated the efficacy and safety of intravenous urapidil relative to that of nitroglycerin in older patients with hypertension and heart failure in a randomized controlled trial.
  
  
  METHODS
  Patients (>60 y) with hypertension and heart failure were randomly assigned to receive intravenous urapidil (n=89) or nitroglycerin (n=91) for 7 days. Hemodynamic parameters, cardiac function, and safety outcomes were compared.
  
  
  RESULTS
  Patients in the urapidil group had significantly lower mean systolic blood pressure (110.1±6.5 mm Hg) than those given nitroglycerin (126.4±8.1 mm Hg, p=0.022), without changes in heart rate. Urapidil was associated with improved cardiac function as reflected by lower N terminal-pro B type natriuretic peptide after 7 days (3311.4±546.1 ng/mL vs. 4879.1±325.7 ng/mL, p=0.027) and improved left ventricular ejection fraction (62.2±3.4% vs. 51.0±2.4%, p=0.032). Patients given urapidil had fewer associated adverse events, specifically headache (p=0.025) and tachycardia (p=0.004). The one-month rehospitalization and all-cause mortality rates were similar.
  
  
  CONCLUSIONS
  Intravenous administration of urapidil, compared with nitroglycerin, was associated with better control of blood pressure and preserved cardiac function, as well as fewer adverse events, for elderly patients with hypertension and acute heart failure.
authors.affiliation: Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Cardiology, An Zhen Hospital affiliated with Capital Medical University, Beijing, China.
authors.forename: Yu Jie
authors.initials: YJ
authors.lastname: Zhou
authors.affiliation: Fu Yan Emergency Department, Tong Ren Hospital affiliated with Capital Medical University, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Fu
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Qin
authors.affiliation: Department of Cardiology, First Hospital affiliated with Chongqing University, Chongqing, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Qin
authors.affiliation: Department of Cardiology, Ningbo First Hospital, Ningbo, China.
authors.forename: Xiao Min
authors.initials: XM
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Luhe Hospital of Beijing Tongzhou District, Beijing, China.
authors.forename: Jin Cheng
authors.initials: JC
authors.lastname: Guo
authors.affiliation: Department of Cardiology, Mentougou District Hospital of Beijing City, Beijing, China.
authors.forename: De Zhao
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Emergency Department, First Hospital affiliated with Sun Yat-sen University, Guangzhou, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhan
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.affiliation: Emergency Department, Xuanwu Hospital, Capital Medical University, Beijing, China.
authors.forename: Jing Yu
authors.initials: JY
authors.lastname: He
authors.affiliation: Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China. huaqi5371@medmail.com.cn.
authors.forename: Qi
authors.initials: Q
authors.lastname: Hua
mesh_terms: D000208:Acute Disease; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002423:Cause of Death; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D005996:Nitroglycerin / Q000008:administration & dosage; D010446:Peptide Fragments / Q000097:blood; D010879:Piperazines / Q000008:administration & dosage*; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents; D010446:Peptide Fragments; D010879:Piperazines; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; C015568:urapidil; D005996:Nitroglycerin
keywords: Urapidil; acute heart failure; hypertension; randomized controlled trial