There is no RCT evidence demonstrating that antihypertensive drugs reduce mortality or morbidity in patients with hypertensive emergencies .
Furthermore , there is insufficient RCT evidence to determine which drug or drug class is most effective in reducing mortality and morbidity .
There were some minor differences in the degree of blood pressure lowering when one class of antihypertensive drug is compared to another .
However , the clinical significance is unknown .
Hypertensive emergencies occur when high blood pressure is associated with the presence of acute end-organ damage , such as hypertensive encephalopathy .
There is controversy as to when and which antihypertensive drugs to use in these situations .
Nicardipine versus Nitroprusside Infusion as Antihypertensive Therapy in Hypertensive Emergencies
This prospect i ve study compared the efficacy of nicardipine and nitroprusside for treating hypertensive emergencies by measuring haemodynamic indices and serum catecholamine levels . Patients admitted to the emergency department with a hypertensive crisis and acute pulmonary oedema received intravenous infusions of nitroprusside ( starting dose 1 μg/kg per min , n = 20 ) or nicardipine ( starting dose 3 μg/kg per min , n = 20 ) . Both groups experienced significant declines in systolic and diastolic blood pressure after treatment , but there were no significant time-dependent differences between the groups . Heart rate decreased in the nicardipine group and increased in the nitroprusside group , but neither change was significant . Respiration rate decreased and capillary oxygen saturation rate increased after treatment in both groups . Adrenaline and noradrenaline levels decreased significantly after treatment in both groups ; noradrenaline levels were significantly decreased in the nicardipine-treated group compared with the nitroprusside-treated group . Injectable nicardipine is easy to use and as effective as nitroprusside for treating hypertensive crisis with acute pulmonary oedema
There is no RCT evidence demonstrating that antihypertensive drugs reduce mortality or morbidity in patients with hypertensive emergencies .
Furthermore , there is insufficient RCT evidence to determine which drug or drug class is most effective in reducing mortality and morbidity .
There were some minor differences in the degree of blood pressure lowering when one class of antihypertensive drug is compared to another .
However , the clinical significance is unknown .
Hypertensive emergencies occur when high blood pressure is associated with the presence of acute end-organ damage , such as hypertensive encephalopathy .
There is controversy as to when and which antihypertensive drugs to use in these situations .