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Nicardipine versus Labetalol for Hypertension during Acute Stroke: A Systematic Review and Meta-Analysis.
Neurol India. 2022 Sep-Oct; 70(5):1793-1799.NI

Abstract

Background and Objective

Current recommendations prescribe either nicardipine or labetalol as the first-line treatment for acute hypertension due to ease of use, availability, and low price. However, it is unclear if these drugs have different effectiveness and safety profiles. This systematic review and meta-analysis aimed to compare the efficacy and safety of labetalol and nicardipine in patients with acute stroke.

Materials and Methods

MEDLINE via PubMed, Scopus, Embase, and Google Scholar databases were electronically searched for the eligible publications from inception until March 2022. All full-text journal papers in English which compared the efficacy of nicardipine with that of labetalol on lowering blood pressure (BP; or treating hypertension) in all subtypes of acute stroke were included. The Cochrane Collaboration tool was used to assess the risk of bias. Data were analyzed using specific statistical methods.

Results

Following the abstract and full-text screening, this meta-analysis included five retrospective cohorts and one prospective pseudorandomized cohort. Nicardipine's effect on time at goal BP was significantly superior to that of labetalol in patients with acute stroke (0.275 standardized mean difference [SMD], 95% confidence interval [CI]: 0.112-0.438, P = 0.001). The incidence of adverse events was significantly higher in the nicardipine group than that in the labetalol group. The pooled odds ratio (OR) was 1.509 (95% CI: 1.077-2.113, I2 = 0.00%, P = 0.757). The quality of included studies was found to be low.

Conclusion

More prospective, comparative trials are needed to investigate the efficacy of BP management as well as clinical outcomes in acute stroke patients receiving continuous labetalol and nicardipine infusions.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Hao F
Department of Neurology, Liaocheng People's Hospital, Shandong Province, China.
Yin S
Department of Operating Room, Liaocheng Veterans Hospital, Shandong Province, China.
Tang L
Department of Neurosurgery, Liaocheng People's Hospital, Shandong Province, China.
Zhang X
Department of Neurosurgery, Liaocheng People's Hospital, Shandong Province, China.
Zhang S
Department of Neurosurgery, Liaocheng People's Hospital, Shandong Province, China.

MeSH

HumansLabetalolNicardipineAntihypertensive AgentsRetrospective StudiesProspective StudiesBlood PressureTreatment OutcomeHypertensionStroke

Pub Type(s)

Meta-Analysis
Systematic Review
Journal Article
Review

Language

eng

PubMed ID

36352567

Citation

Hao, Fang, et al. "Nicardipine Versus Labetalol for Hypertension During Acute Stroke: a Systematic Review and Meta-Analysis." Neurology India, vol. 70, no. 5, 2022, pp. 1793-1799.
Hao F, Yin S, Tang L, et al. Nicardipine versus Labetalol for Hypertension during Acute Stroke: A Systematic Review and Meta-Analysis. Neurol India. 2022;70(5):1793-1799.
Hao, F., Yin, S., Tang, L., Zhang, X., & Zhang, S. (2022). Nicardipine versus Labetalol for Hypertension during Acute Stroke: A Systematic Review and Meta-Analysis. Neurology India, 70(5), 1793-1799. https://doi.org/10.4103/0028-3886.359214
Hao F, et al. Nicardipine Versus Labetalol for Hypertension During Acute Stroke: a Systematic Review and Meta-Analysis. Neurol India. 2022 Sep-Oct;70(5):1793-1799. PubMed PMID: 36352567.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nicardipine versus Labetalol for Hypertension during Acute Stroke: A Systematic Review and Meta-Analysis. AU - Hao,Fang, AU - Yin,Suna, AU - Tang,Lina, AU - Zhang,Xueguang, AU - Zhang,Shubao, PY - 2022/11/10/entrez PY - 2022/11/11/pubmed PY - 2022/11/15/medline KW - Hypertension KW - labetalol KW - meta-analysis KW - nicardipine KW - stroke SP - 1793 EP - 1799 JF - Neurology India JO - Neurol India VL - 70 IS - 5 N2 - Background and Objective: Current recommendations prescribe either nicardipine or labetalol as the first-line treatment for acute hypertension due to ease of use, availability, and low price. However, it is unclear if these drugs have different effectiveness and safety profiles. This systematic review and meta-analysis aimed to compare the efficacy and safety of labetalol and nicardipine in patients with acute stroke. Materials and Methods: MEDLINE via PubMed, Scopus, Embase, and Google Scholar databases were electronically searched for the eligible publications from inception until March 2022. All full-text journal papers in English which compared the efficacy of nicardipine with that of labetalol on lowering blood pressure (BP; or treating hypertension) in all subtypes of acute stroke were included. The Cochrane Collaboration tool was used to assess the risk of bias. Data were analyzed using specific statistical methods. Results: Following the abstract and full-text screening, this meta-analysis included five retrospective cohorts and one prospective pseudorandomized cohort. Nicardipine's effect on time at goal BP was significantly superior to that of labetalol in patients with acute stroke (0.275 standardized mean difference [SMD], 95% confidence interval [CI]: 0.112-0.438, P = 0.001). The incidence of adverse events was significantly higher in the nicardipine group than that in the labetalol group. The pooled odds ratio (OR) was 1.509 (95% CI: 1.077-2.113, I2 = 0.00%, P = 0.757). The quality of included studies was found to be low. Conclusion: More prospective, comparative trials are needed to investigate the efficacy of BP management as well as clinical outcomes in acute stroke patients receiving continuous labetalol and nicardipine infusions. SN - 1998-4022 UR - https://www.unboundmedicine.com/medline/citation/36352567/Nicardipine_versus_Labetalol_for_Hypertension_during_Acute_Stroke:_A_Systematic_Review_and_Meta_Analysis_ DB - PRIME DP - Unbound Medicine ER -