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Treatment of postoperative hypertension after coronary artery bypass surgery: Double-blind comparison of intravenous isradipine and sodium nitroprusside

Publication ,  Journal Article
Leslie, J; Brister, N; Levy, JH; Yared, JP; Marty, A; Martin, H; Hines, R; Savino, J; Cohen, M
Published in: Circulation
January 1, 1994

Background: Hypertension commonly occurs after cardiac surgery and requires therapy to prevent the potentially deleterious effects. Methods and Results: After coronary artery bypass graft surgery (CABG), 177 patients with elevated blood pressure ≥90 mm Hg during the initial 6-hour postsurgical period were selected for this random blinded, parallel study to receive intravenous infusions of either isradipine (n=90) or sodium nitroprusside (n=87). Isradipine produced a statistically significant decrease in mean arterial pressure (MAP, Δ-23 mm Hg) during a 90-minute treatment period. Target MAP (≤85 mm Hg or a decrease of 10 mm Hg, if baseline MAP was between 90 and 95 mm Hg) was achieved in 94% of patients 30 minutes after initiation of isradipine infusion (total mean dose, 411 μg); target MAP was achieved in 75% of nitroprusside-treated patients (total mean dose, 1708 μg). The mean time to control MAP was 18 minutes for isradipine compared with 24 minutes for nitroprusside. Global smoothness in MAP control was graded on a scale of 0 (not controlled) to 5 (excellent). Approximately 76% of isradipine-treated patients received a rating of ≥3 (mean score, 3.5); 40% of the sodium nitroprusside-treated patients achieved a score of ≥3 (mean score, 2.0). Both isradipine and nitroprusside produced statistically significant reductions in systolic and diastolic blood pressures, a decrease in systemic vascular resistance, and increases in heart rate, cardiac index, and stroke volume index. Isradipine produced no significant decreases in pulmonary artery occlusion wedge pressure compared with nitroprusside. Conclusions: Intravenous isradipine was effective and well tolerated in patients with hypertension after CABG and offers an additional therapeutic option to treat patients after cardiac surgery.

Duke Scholars

Published In

Circulation

ISSN

0009-7322

Publication Date

January 1, 1994

Volume

90

Issue

5 II

Related Subject Headings

  • Cardiovascular System & Hematology
  • 4207 Sports science and exercise
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1117 Public Health and Health Services
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology
 

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Leslie, J., Brister, N., Levy, J. H., Yared, J. P., Marty, A., Martin, H., … Cohen, M. (1994). Treatment of postoperative hypertension after coronary artery bypass surgery: Double-blind comparison of intravenous isradipine and sodium nitroprusside. Circulation, 90(5 II).
Leslie, J., N. Brister, J. H. Levy, J. P. Yared, A. Marty, H. Martin, R. Hines, J. Savino, and M. Cohen. “Treatment of postoperative hypertension after coronary artery bypass surgery: Double-blind comparison of intravenous isradipine and sodium nitroprusside.” Circulation 90, no. 5 II (January 1, 1994).
Leslie J, Brister N, Levy JH, Yared JP, Marty A, Martin H, Hines R, Savino J, Cohen M. Treatment of postoperative hypertension after coronary artery bypass surgery: Double-blind comparison of intravenous isradipine and sodium nitroprusside. Circulation. 1994 Jan 1;90(5 II).

Published In

Circulation

ISSN

0009-7322

Publication Date

January 1, 1994

Volume

90

Issue

5 II

Related Subject Headings

  • Cardiovascular System & Hematology
  • 4207 Sports science and exercise
  • 3202 Clinical sciences
  • 3201 Cardiovascular medicine and haematology
  • 1117 Public Health and Health Services
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology