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A comparison of nicardipine and labetalol for acute hypertension management following stroke.
Neurocrit Care. 2008; 9(2):167-76.NC

Abstract

OBJECTIVE

Evaluate the ease of use and tolerability of labetalol (L) and nicardipine (N) for hypertension management in patients with acute stroke.

METHODS

This is a retrospective, non-randomized study. Consecutive adults within 24 h of hospital admission who received intravenous bolus labetalol or nicardipine infusion as first-line antihypertensive therapy were identified. Hemodynamic data were collected through 24 h of therapy.

RESULTS

Ninety patients received either labetalol (N = 64) or nicardipine (N = 26) initially for blood pressure (BP) management. Stroke types were 54% intracerebral hemorrhage (ICH), 22% subarachnoid hemorrhage, and 23% ischemic stroke and were similar between the two drug groups. Baseline patient characteristics and disease severity (APACHE II and GCS) were similar between groups. The average total daily labetalol dose was 40 (10-340) mg and nicardipine infusion was 5 (1-14) mg/h. Initial BP was similar in the two groups. The nicardipine group had less BP variability (N 8.19 vs. L 10.78 mmHg; p = 0.003), fewer dosage adjustments [L 4 (1-17), N 2 (0-5); p < 0.001] and fewer additional antihypertensive agents (L 33%, N 8%; p = 0.013) administered during the 24-h observation period. In patients with ICH, 33% of nicardipine-treated patients achieved target BP within the first 60 min versus 6% of the L group (p = 0.02). Overall, incidence of hypotension (SBP < 90 mmHg) (L 3%; N 0%) and bradycardia (HR < 60 beats per min) (L 20.6%; N 12%) were comparable between the groups.

CONCLUSIONS

Nicardipine offers an alternative to labetalol with similar tolerability and appears to provide a smoother blood pressure control compared to labetalol.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Liu-Deryke X
Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, 48201, USA.
Janisse J
No affiliation info available
Coplin WM
No affiliation info available
Parker D
No affiliation info available
Norris G
No affiliation info available
Rhoney DH
No affiliation info available

MeSH

APACHEAcute DiseaseAgedAntihypertensive AgentsBlood PressureBrain IschemiaCerebral HemorrhageFemaleHumansHypertensionLabetalolMaleMiddle AgedNicardipineRetrospective StudiesStrokeTreatment Outcome

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18250979

Citation

Liu-Deryke, Xi, et al. "A Comparison of Nicardipine and Labetalol for Acute Hypertension Management Following Stroke." Neurocritical Care, vol. 9, no. 2, 2008, pp. 167-76.
Liu-Deryke X, Janisse J, Coplin WM, et al. A comparison of nicardipine and labetalol for acute hypertension management following stroke. Neurocrit Care. 2008;9(2):167-76.
Liu-Deryke, X., Janisse, J., Coplin, W. M., Parker, D., Norris, G., & Rhoney, D. H. (2008). A comparison of nicardipine and labetalol for acute hypertension management following stroke. Neurocritical Care, 9(2), 167-76. https://doi.org/10.1007/s12028-008-9057-z
Liu-Deryke X, et al. A Comparison of Nicardipine and Labetalol for Acute Hypertension Management Following Stroke. Neurocrit Care. 2008;9(2):167-76. PubMed PMID: 18250979.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of nicardipine and labetalol for acute hypertension management following stroke. AU - Liu-Deryke,Xi, AU - Janisse,James, AU - Coplin,William M, AU - Parker,Dennis,Jr AU - Norris,Gregory, AU - Rhoney,Denise H, PY - 2008/2/6/pubmed PY - 2008/12/20/medline PY - 2008/2/6/entrez SP - 167 EP - 76 JF - Neurocritical care JO - Neurocrit Care VL - 9 IS - 2 N2 - OBJECTIVE: Evaluate the ease of use and tolerability of labetalol (L) and nicardipine (N) for hypertension management in patients with acute stroke. METHODS: This is a retrospective, non-randomized study. Consecutive adults within 24 h of hospital admission who received intravenous bolus labetalol or nicardipine infusion as first-line antihypertensive therapy were identified. Hemodynamic data were collected through 24 h of therapy. RESULTS: Ninety patients received either labetalol (N = 64) or nicardipine (N = 26) initially for blood pressure (BP) management. Stroke types were 54% intracerebral hemorrhage (ICH), 22% subarachnoid hemorrhage, and 23% ischemic stroke and were similar between the two drug groups. Baseline patient characteristics and disease severity (APACHE II and GCS) were similar between groups. The average total daily labetalol dose was 40 (10-340) mg and nicardipine infusion was 5 (1-14) mg/h. Initial BP was similar in the two groups. The nicardipine group had less BP variability (N 8.19 vs. L 10.78 mmHg; p = 0.003), fewer dosage adjustments [L 4 (1-17), N 2 (0-5); p < 0.001] and fewer additional antihypertensive agents (L 33%, N 8%; p = 0.013) administered during the 24-h observation period. In patients with ICH, 33% of nicardipine-treated patients achieved target BP within the first 60 min versus 6% of the L group (p = 0.02). Overall, incidence of hypotension (SBP < 90 mmHg) (L 3%; N 0%) and bradycardia (HR < 60 beats per min) (L 20.6%; N 12%) were comparable between the groups. CONCLUSIONS: Nicardipine offers an alternative to labetalol with similar tolerability and appears to provide a smoother blood pressure control compared to labetalol. SN - 1541-6933 UR - https://www.unboundmedicine.com/medline/citation/18250979/A_comparison_of_nicardipine_and_labetalol_for_acute_hypertension_management_following_stroke_ DB - PRIME DP - Unbound Medicine ER -