Efficacy and Safety of Intravenous Urapidil for Older Hypertensive Patients with Acute Heart Failure: A Multicenter Randomized Controlled Trial
| Autor: | Qi Hua, Jing Yu He, Wei Yang, Jin Cheng Guo, Shu Qin, Jian Qin, Xiao Min Chen, De Zhao Wang, Hong Zhan, Yujie Zhou, Yan Fu, Jing Li |
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| Rok vydání: | 2016 |
| Předmět: |
Tachycardia
Cardiac function curve Male medicine.medical_specialty Cardiac & Cardiovascular Systems hypertension acute heart failure Hemodynamics Blood Pressure 030204 cardiovascular system & hematology Urapidil Piperazines Ventricular Function Left 03 medical and health sciences Nitroglycerin 0302 clinical medicine Heart Rate Internal medicine Cause of Death Heart rate Natriuretic Peptide Brain Medicine Humans 030212 general & internal medicine Antihypertensive Agents Aged Heart Failure Ejection fraction business.industry General Medicine Middle Aged medicine.disease Peptide Fragments Blood pressure Anesthesia Heart failure Acute Disease Injections Intravenous randomized controlled trial Cardiology Female Original Article medicine.symptom business |
| Zdroj: | Yonsei Medical Journal |
| ISSN: | 1976-2437 |
| Popis: | Purpose Urapidil is putatively effective for patients with hypertension and acute heart failure, although randomized controlled trials thereon are lacking. We investigated the efficacy and safety of intravenous urapidil relative to that of nitroglycerin in older patients with hypertension and heart failure in a randomized controlled trial. Materials and methods Patients (>60 y) with hypertension and heart failure were randomly assigned to receive intravenous urapidil (n=89) or nitroglycerin (n=91) for 7 days. Hemodynamic parameters, cardiac function, and safety outcomes were compared. Results Patients in the urapidil group had significantly lower mean systolic blood pressure (110.1±6.5 mm Hg) than those given nitroglycerin (126.4±8.1 mm Hg, p=0.022), without changes in heart rate. Urapidil was associated with improved cardiac function as reflected by lower N terminal-pro B type natriuretic peptide after 7 days (3311.4±546.1 ng/mL vs. 4879.1±325.7 ng/mL, p=0.027) and improved left ventricular ejection fraction (62.2±3.4% vs. 51.0±2.4%, p=0.032). Patients given urapidil had fewer associated adverse events, specifically headache (p=0.025) and tachycardia (p=0.004). The one-month rehospitalization and all-cause mortality rates were similar. Conclusion Intravenous administration of urapidil, compared with nitroglycerin, was associated with better control of blood pressure and preserved cardiac function, as well as fewer adverse events, for elderly patients with hypertension and acute heart failure. |
| Databáze: | OpenAIRE |
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