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The following is a summary of “Evaluation of the Efficacy and Safety of Nicardipine Versus Clevidipine for Blood Pressure Control in Hypertensive Crisis,” published in the October 2024 issue of Emergency Medicine by Storey et al.
A hypertensive crisis is an emergency described by a sudden and severe increase in blood pressure >180/120 mm Hg. Titratable antihypertensive agents like nicardipine and clevidipine effectively manage this condition.
Researchers conducted a retrospective study to evaluate the efficacy and safety of nicardipine or clevidipine for blood pressure control in hypertensive crisis.
They examined patients who received nicardipine or clevidipine for hypertensive crisis. The primary outcome was a 25% drop in mean arterial pressure within 1 hour, while the secondary outcome was a systolic blood pressure (SBP) below 160 mm Hg within 2-6 hours of starting the infusion.
The results showed that among 156 patients, 74 were in the nicardipine and 82 in the clevidipine group. The SBP on admission and at infusion initiation were comparable between both groups and had no significant difference in achieving a 25% reduction in mean arterial pressure at 1 hour. However, nicardipine was more successful in acquiring an SBP goal of less than 160 mm Hg between 2 to 6 hours compared to the clevidipine group (89.2% vs 73.2%; P=0.011).
They concluded that there was no difference between agents for initial blood pressure control in the treatment of hypertensive crisis. Still, nicardipine showed more sustained SBP control with a lower risk of rebound hypertension and significant cost savings compared to clevidipine.
Source: sciencedirect.com/science/article/abs/pii/S0736467924001355
