Category Archives: Pulmonary Hypertension

Canadian Neighbor Pharmacy: A Randomized Comparison of Nifedipine and Sodium Nitroprusside in Severe Hypertension

Hypertensive emergenciesHypertensive emergencies, characterized by extreme elevations of blood pressure and acute end organ damage specific to the heart, central nervous system, or kidneys, account for 3 to 5 percent of all admissions to medical intensive care units. The standard treatment for the hypertensive emergency has traditionally been to administer intravenous vasodilator therapy in a closely supervised setting. Therapy with nitroprusside, the most commonly used initial agent for blood pressure reduction, usually entails admission to an intensive care unit with an indwelling arterial catheter placed for continuous blood pressure monitoring. A number of current reports describe the treatment of hypertensive emergencies with nifedipine, an oral calcium channel blocking agent. Theoretically, oral nifedipine carries several advantages over intravenous nitroprusside—ease of administration, less complex and expensive monitoring, and no treatment delay while a patient is being transferred to an ICU. To date, no randomized trial has been performed comparing nitroprusside and nifedipine in patients with severe hypertension.