INTRODUCTION: Acute hypertension is common following stroke and contributes to poor outcomes. Labetalol and nicardipine are often used for acute hypertension but there are little data comparing the two. This study is to evaluate the therapeutic response and tolerability of these two agents following acute stroke. METHODS: This is a prospective, pseudo-randomized study comparing labetalol and nicardipine for blood pressure (BP) management in acute stroke patients. Patients who presented to the emergency department (ED) with confirmed hemorrhagic or ischemic stroke received eitherlabetalol or nicardipinefor 24 h from ED admission. Therapeutic response was assessed by achievement of goal BP, time spent within goal, and variability in BP. Clinical outcomes including length of stay, clinical status at discharge, and in-hospital mortality were recorded. RESULTS:54 patients were enrolled (labetalol = 28; nicardipine = 26) with 25 ± 6 BP measurements per patient. Majority of patients had a hemorrhagic stroke and baseline characteristics were similar between groups. All patients who received nicardipine achieved goal BP compared to 17 (61 %) in the labetalol group (p < 0.001) with 89 % nicardipine-treated patients achieved goal BP within 60 min of drug initiation versus 25 % in labetalol group (p < 0.001). Nicardipine group had better maintenance of BP, a greater percentage of time spent within goal, and significantly less BP variability compared to labetalol group (p < 0.001). Less rescue antihypertensive agents were given to nicardipine group than labetalol group (p < 0.001). The incidences of adverse drug events were similar between groups and there were no differences in clinical outcomes. CONCLUSION: In acutely hypertensive stroke patients, superior therapeutic response was achieved with nicardipine versus labetalol. Despite this, there was no demonstrable difference in clinical outcomes.
RCT Entities:
INTRODUCTION: Acute hypertension is common following stroke and contributes to poor outcomes. Labetalol and nicardipine are often used for acute hypertension but there are little data comparing the two. This study is to evaluate the therapeutic response and tolerability of these two agents following acute stroke. METHODS: This is a prospective, pseudo-randomized study comparing labetalol and nicardipine for blood pressure (BP) management in acute strokepatients. Patients who presented to the emergency department (ED) with confirmed hemorrhagic or ischemic stroke received either labetalol or nicardipine for 24 h from ED admission. Therapeutic response was assessed by achievement of goal BP, time spent within goal, and variability in BP. Clinical outcomes including length of stay, clinical status at discharge, and in-hospital mortality were recorded. RESULTS: 54 patients were enrolled (labetalol = 28; nicardipine = 26) with 25 ± 6 BP measurements per patient. Majority of patients had a hemorrhagic stroke and baseline characteristics were similar between groups. All patients who received nicardipine achieved goal BP compared to 17 (61 %) in the labetalol group (p < 0.001) with 89 % nicardipine-treated patients achieved goal BP within 60 min of drug initiation versus 25 % in labetalol group (p < 0.001). Nicardipine group had better maintenance of BP, a greater percentage of time spent within goal, and significantly less BP variability compared to labetalol group (p < 0.001). Less rescue antihypertensive agents were given to nicardipine group than labetalol group (p < 0.001). The incidences of adverse drug events were similar between groups and there were no differences in clinical outcomes. CONCLUSION: In acutely hypertensive strokepatients, superior therapeutic response was achieved with nicardipine versus labetalol. Despite this, there was no demonstrable difference in clinical outcomes.
Authors: Adnan I Qureshi; Yuko Y Palesch; Reneé Martin; Jill Novitzke; Salvador Cruz-Flores; As'ad Ehtisham; Mustapha A Ezzeddine; Joshua N Goldstein; Haitham M Hussein; M Fareed K Suri; Nauman Tariq Journal: Arch Neurol Date: 2010-05
Authors: Joshua B Bederson; E Sander Connolly; H Hunt Batjer; Ralph G Dacey; Jacques E Dion; Michael N Diringer; John E Duldner; Robert E Harbaugh; Aman B Patel; Robert H Rosenwasser Journal: Stroke Date: 2009-01-22 Impact factor: 7.914
Authors: Craig S Anderson; Yining Huang; Hisatomi Arima; Emma Heeley; Christian Skulina; Mark W Parsons; Bin Peng; Qiang Li; Steve Su; Qing Ling Tao; Yue Chun Li; Jian Dong Jiang; Li Wen Tai; Jin Li Zhang; En Xu; Yan Cheng; Lewis B Morgenstern; John Chalmers; Ji Guang Wang Journal: Stroke Date: 2009-12-31 Impact factor: 7.914
Authors: R Delgado-Mederos; M Ribo; A Rovira; M Rubiera; J Munuera; E Santamarina; P Delgado; O Maisterra; J Alvarez-Sabin; C A Molina Journal: Neurology Date: 2008-06-11 Impact factor: 9.910
Authors: W Frank Peacock; Joseph Varon; Brigitte M Baumann; Pierre Borczuk; Chad M Cannon; Abhinav Chandra; David M Cline; Deborah Diercks; Brian Hiestand; A Hsu; Preeti Jois-Bilowich; Brian Kaminski; Philip Levy; Richard M Nowak; Jon W Schrock Journal: Crit Care Date: 2011-06-27 Impact factor: 9.097
Authors: Janelle O Poyant; Philip J Kuper; Kristin C Mara; Ross A Dierkhising; Alejandro A Rabinstein; Eelco F M Wijdicks; Brianne M Ritchie Journal: Neurocrit Care Date: 2019-02 Impact factor: 3.210
Authors: Abdulrahman I Alshaya; Meshari Alghamdi; Sumaya N Almohareb; Omar A Alshaya; Mohammed Aldhaeefi; Abdullah F Alharthi; Sulaiman Almohaish Journal: Front Neurol Date: 2022-07-01 Impact factor: 4.086
Authors: Airton Leonardo de Oliveira Manoel; Alberto Goffi; Fernando Godinho Zampieri; David Turkel-Parrella; Abhijit Duggal; Thomas R Marotta; R Loch Macdonald; Simon Abrahamson Journal: Crit Care Date: 2016-09-18 Impact factor: 9.097
Authors: Quincy K Tran; Daniel Najafali; Laura Tiffany; Safura Tanveer; Brooke Andersen; Michelle Dawson; Rachel Hausladen; Matthew Jackson; Ann Matta; Jordan Mitchell; Christopher Yum; Diane Kuhn Journal: West J Emerg Med Date: 2021-01-12