A Prospective Evaluation of Labetalol Versus Nicardipine for Blood Pressure Management in Patients with Acute Stroke
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...
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| Veröffentlicht in: | Neurocritical care 2013-08, Vol.19 (1), p.41-47 |
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| description | 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 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
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| doi_str_mv | 10.1007/s12028-013-9863-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1427010758</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1427010758</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-cad3ba7422d62576f874762ca9ff01b4c2ad196f65c6174e7acbbe7358c2324f3</originalsourceid><addsrcrecordid>eNp1kU1rFTEUhoNYbK3-ADcScONmNN-ZLK-ltYXbWvBjGzKZk5o6d3JNMpX-e3O51YLgJjlwnvMknBehV5S8o4To94UywvqOUN6ZXrXjCTqiUqqOGEWf7mpBO2U4P0TPS7klhGmj5TN0yLhWxFB6hOoKX-dUtuBrvAN8euemxdWYZpwCXrsBqpvShL9BLkvBV9G7PMZtnAGHlPGHKaWxCaCUJQO-dLO7gQ3MFccZXzdPKwv-Fet3vPJLBfy55vQDXqCD4KYCLx_uY_T17PTLyXm3_vTx4mS17rwgsnbejXxwWjA2Kia1Cr0WWjHvTAiEDsIzN1KjgpJeUS1AOz8MoLnsPeNMBH6M3u6925x-LlCq3cTiYZrcDGkplgqmCSVa9g198w96m5Y8t99ZZqiRhAuxo-ie8m1nJUOw2xw3Lt9bSuwuEruPxLZI7C4Sa9rM6wfzMmxg_DvxJ4MGsD1QWmu-gfz49P-tvwF7npb1</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2919503448</pqid></control><display><type>article</type><title>A Prospective Evaluation of Labetalol Versus Nicardipine for Blood Pressure Management in Patients with Acute Stroke</title><source>MEDLINE</source><source>ProQuest Central (Alumni Edition)</source><source>ProQuest Central UK/Ireland</source><source>SpringerLink Journals - AutoHoldings</source><source>ProQuest Central</source><creator>Liu-DeRyke, Xi ; Levy, Phillip D. ; Parker, Dennis ; Coplin, William ; Rhoney, Denise H.</creator><creatorcontrib>Liu-DeRyke, Xi ; Levy, Phillip D. ; Parker, Dennis ; Coplin, William ; Rhoney, Denise H.</creatorcontrib><description>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 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 stroke patients, superior therapeutic response was achieved with nicardipine versus labetalol. Despite this, there was no demonstrable difference in clinical outcomes.</description><identifier>ISSN: 1541-6933</identifier><identifier>EISSN: 1556-0961</identifier><identifier>DOI: 10.1007/s12028-013-9863-9</identifier><identifier>PMID: 23760911</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Aged ; Antihypertensive Agents - administration & dosage ; Antihypertensive Agents - adverse effects ; Antihypertensives ; APACHE ; Blood pressure ; Blood Pressure - drug effects ; Cardiac arrhythmia ; Critical Care Medicine ; Female ; Heart rate ; Hematoma ; Hemorrhage ; Hospital Mortality ; Humans ; Hypertension ; Hypertension - drug therapy ; Hypertension - etiology ; Hypertension - mortality ; Intensive ; Internal Medicine ; Ischemia ; Labetalol - administration & dosage ; Labetalol - adverse effects ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurology ; Nicardipine - administration & dosage ; Nicardipine - adverse effects ; Original Article ; Prospective Studies ; Stroke ; Stroke - complications ; Stroke - drug therapy ; Stroke - mortality ; Treatment Outcome ; Variables ; Vital signs</subject><ispartof>Neurocritical care, 2013-08, Vol.19 (1), p.41-47</ispartof><rights>Springer Science+Business Media New York 2013</rights><rights>Springer Science+Business Media New York 2013.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-cad3ba7422d62576f874762ca9ff01b4c2ad196f65c6174e7acbbe7358c2324f3</citedby><cites>FETCH-LOGICAL-c405t-cad3ba7422d62576f874762ca9ff01b4c2ad196f65c6174e7acbbe7358c2324f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12028-013-9863-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2919503448?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21388,21389,27924,27925,33530,33531,33744,33745,41488,42557,43659,43805,51319,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23760911$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu-DeRyke, Xi</creatorcontrib><creatorcontrib>Levy, Phillip D.</creatorcontrib><creatorcontrib>Parker, Dennis</creatorcontrib><creatorcontrib>Coplin, William</creatorcontrib><creatorcontrib>Rhoney, Denise H.</creatorcontrib><title>A Prospective Evaluation of Labetalol Versus Nicardipine for Blood Pressure Management in Patients with Acute Stroke</title><title>Neurocritical care</title><addtitle>Neurocrit Care</addtitle><addtitle>Neurocrit Care</addtitle><description>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 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 stroke patients, superior therapeutic response was achieved with nicardipine versus labetalol. Despite this, there was no demonstrable difference in clinical outcomes.</description><subject>Aged</subject><subject>Antihypertensive Agents - administration & dosage</subject><subject>Antihypertensive Agents - adverse effects</subject><subject>Antihypertensives</subject><subject>APACHE</subject><subject>Blood pressure</subject><subject>Blood Pressure - drug effects</subject><subject>Cardiac arrhythmia</subject><subject>Critical Care Medicine</subject><subject>Female</subject><subject>Heart rate</subject><subject>Hematoma</subject><subject>Hemorrhage</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - etiology</subject><subject>Hypertension - mortality</subject><subject>Intensive</subject><subject>Internal Medicine</subject><subject>Ischemia</subject><subject>Labetalol - administration & dosage</subject><subject>Labetalol - adverse effects</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Nicardipine - administration & dosage</subject><subject>Nicardipine - adverse effects</subject><subject>Original Article</subject><subject>Prospective Studies</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Stroke - drug therapy</subject><subject>Stroke - mortality</subject><subject>Treatment Outcome</subject><subject>Variables</subject><subject>Vital signs</subject><issn>1541-6933</issn><issn>1556-0961</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1rFTEUhoNYbK3-ADcScONmNN-ZLK-ltYXbWvBjGzKZk5o6d3JNMpX-e3O51YLgJjlwnvMknBehV5S8o4To94UywvqOUN6ZXrXjCTqiUqqOGEWf7mpBO2U4P0TPS7klhGmj5TN0yLhWxFB6hOoKX-dUtuBrvAN8euemxdWYZpwCXrsBqpvShL9BLkvBV9G7PMZtnAGHlPGHKaWxCaCUJQO-dLO7gQ3MFccZXzdPKwv-Fet3vPJLBfy55vQDXqCD4KYCLx_uY_T17PTLyXm3_vTx4mS17rwgsnbejXxwWjA2Kia1Cr0WWjHvTAiEDsIzN1KjgpJeUS1AOz8MoLnsPeNMBH6M3u6925x-LlCq3cTiYZrcDGkplgqmCSVa9g198w96m5Y8t99ZZqiRhAuxo-ie8m1nJUOw2xw3Lt9bSuwuEruPxLZI7C4Sa9rM6wfzMmxg_DvxJ4MGsD1QWmu-gfz49P-tvwF7npb1</recordid><startdate>20130801</startdate><enddate>20130801</enddate><creator>Liu-DeRyke, Xi</creator><creator>Levy, Phillip D.</creator><creator>Parker, Dennis</creator><creator>Coplin, William</creator><creator>Rhoney, Denise H.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7TK</scope></search><sort><creationdate>20130801</creationdate><title>A Prospective Evaluation of Labetalol Versus Nicardipine for Blood Pressure Management in Patients with Acute Stroke</title><author>Liu-DeRyke, Xi ; Levy, Phillip D. ; Parker, Dennis ; Coplin, William ; Rhoney, Denise H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-cad3ba7422d62576f874762ca9ff01b4c2ad196f65c6174e7acbbe7358c2324f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Antihypertensive Agents - administration & dosage</topic><topic>Antihypertensive Agents - adverse effects</topic><topic>Antihypertensives</topic><topic>APACHE</topic><topic>Blood pressure</topic><topic>Blood Pressure - drug effects</topic><topic>Cardiac arrhythmia</topic><topic>Critical Care Medicine</topic><topic>Female</topic><topic>Heart rate</topic><topic>Hematoma</topic><topic>Hemorrhage</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - etiology</topic><topic>Hypertension - mortality</topic><topic>Intensive</topic><topic>Internal Medicine</topic><topic>Ischemia</topic><topic>Labetalol - administration & dosage</topic><topic>Labetalol - adverse effects</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Nicardipine - administration & dosage</topic><topic>Nicardipine - adverse effects</topic><topic>Original Article</topic><topic>Prospective Studies</topic><topic>Stroke</topic><topic>Stroke - complications</topic><topic>Stroke - drug therapy</topic><topic>Stroke - mortality</topic><topic>Treatment Outcome</topic><topic>Variables</topic><topic>Vital signs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu-DeRyke, Xi</creatorcontrib><creatorcontrib>Levy, Phillip D.</creatorcontrib><creatorcontrib>Parker, Dennis</creatorcontrib><creatorcontrib>Coplin, William</creatorcontrib><creatorcontrib>Rhoney, Denise H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Neurosciences Abstracts</collection><jtitle>Neurocritical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu-DeRyke, Xi</au><au>Levy, Phillip D.</au><au>Parker, Dennis</au><au>Coplin, William</au><au>Rhoney, Denise H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Prospective Evaluation of Labetalol Versus Nicardipine for Blood Pressure Management in Patients with Acute Stroke</atitle><jtitle>Neurocritical care</jtitle><stitle>Neurocrit Care</stitle><addtitle>Neurocrit Care</addtitle><date>2013-08-01</date><risdate>2013</risdate><volume>19</volume><issue>1</issue><spage>41</spage><epage>47</epage><pages>41-47</pages><issn>1541-6933</issn><eissn>1556-0961</eissn><abstract>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 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 stroke patients, superior therapeutic response was achieved with nicardipine versus labetalol. Despite this, there was no demonstrable difference in clinical outcomes.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>23760911</pmid><doi>10.1007/s12028-013-9863-9</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1541-6933 |
| ispartof | Neurocritical care, 2013-08, Vol.19 (1), p.41-47 |
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| language | eng |
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| source | MEDLINE; ProQuest Central (Alumni Edition); ProQuest Central UK/Ireland; SpringerLink Journals - AutoHoldings; ProQuest Central |
| subjects | Aged Antihypertensive Agents - administration & dosage Antihypertensive Agents - adverse effects Antihypertensives APACHE Blood pressure Blood Pressure - drug effects Cardiac arrhythmia Critical Care Medicine Female Heart rate Hematoma Hemorrhage Hospital Mortality Humans Hypertension Hypertension - drug therapy Hypertension - etiology Hypertension - mortality Intensive Internal Medicine Ischemia Labetalol - administration & dosage Labetalol - adverse effects Male Medicine Medicine & Public Health Middle Aged Neurology Nicardipine - administration & dosage Nicardipine - adverse effects Original Article Prospective Studies Stroke Stroke - complications Stroke - drug therapy Stroke - mortality Treatment Outcome Variables Vital signs |
| title | A Prospective Evaluation of Labetalol Versus Nicardipine for Blood Pressure Management in Patients with Acute Stroke |
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