Nifedipine-Associated Myocardial Ischemia or Infarction in the Treatment of Hypertensive Urgencies
Authors: JAMES J. O'MAILIA
Journal: Annals of Internal Medicine (1987)

Brief Reports1 August 1987Nifedipine-Associated Myocardial Ischemia or Infarction in the Treatment of Hypertensive UrgenciesJAMES J. O'MAILIA, M.D., GARY E. SANDER, M.D., Ph.D., THOMAS D. GILES, M.D.JAMES J. O'MAILIA, M.D., GARY E. SANDER, M.D., Ph.D., THOMAS D. GILES, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-107-2-185 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPatients receiving sublingual nifedipine for hypertensive emergencies have had good therapeutic responses (1-3) and few serious side effects such as hypotension (2-5). However, previous studies of the use of calcium antagonists as antianginal agents have shown that these drugs, particularly dihydropyridines such as nifedipine, may cause hypotension and myocardial ischemia (6, 7). Many patients presenting with severe hypertension have coronary artery disease or left ventricular hypertrophy; we report the cases of three patients who had clinically important myocardial ischemic events associated with the use of sublingual nifedipine.Patient 1:A 55-year-old woman with a history of controlled essential hypertension presented...References1. FRISHMAN W, WEINBERG P, PELED H, KIMMEL B, CHARLAP S, and BEER N. Calcium entry blockers for the treatment of severe hypertension and hypertensive crisis. Am J Med. 1984;77:35-45. CrossrefMedlineGoogle Scholar2. JENNINGS A, JEE L, SMITH J, COMMERFORD P, and OPIE L. Acute effect of nifedipine on blood pressure and left ventricular ejection fraction in severely hypertensive outpatients: predictive effects of acute therapy and prolonged efficacy when added to existing therapy. Am Heart J. 1986;111:557-63. CrossrefMedlineGoogle Scholar3. HOUSTON M. Treatment of hypertensive urgencies and emergencies with nifedipine. 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JAMA. 1976;235:275-6. CrossrefMedlineGoogle Scholar10. MONTOLIU J, BOTEY A, PONS J, and REVERT L. Fatal hypotension in normal-dose nitroprusside therapy [Letter]. Am Heart J. 1979;97:541-2. CrossrefMedlineGoogle Scholar11. HAMBY W, JANKOWSKI G, POUGET J, DUNEA G, and GANTT C. Intravenous use of diazoxide in the treatment of severe hypertension. Circulation. 1968;37:169-4. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JAMES J. O'MAILIA, M.D.; GARY E. SANDER, M.D., Ph.D.; THOMAS D. 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The first 24 hours.HypertensionManagement of hypertensive patients with cardiac problemsβ-Adrenoceptor antagonists and antianginal drugsNifedipine, Hypotension, and Myocardial InjuryANDREW D. LEAVITT, M.D., ANDREW J. ZWEIFLER, M.D. 1 August 1987Volume 107, Issue 2Page: 185-186KeywordsCalciumDrugsHistory of medicineHypertensionHypotensionInfarctionIschemiaLeft ventricular hypertrophyMyocardial infarctionStable coronary artery disease ePublished: 1 December 2008 Issue Published: 1 August 1987 PDF downloadLoading ...