Isradipine for treatment of acute hypertension after myocardial revascularization.
OBJECTIVE: To evaluate the efficacy and duration of action of iv isradipine in the control of postoperative hypertension immediately after myocardial revascularization. DESIGN: Prospective, phase 2 trial. SETTING: Surgical ICU, university hospital. PATIENTS: Twenty-one (15 male, six female) patients, ages 49 to 75 yr (mean 65 +/- 5), undergoing elective myocardial revascularization. INTERVENTIONS: Twenty-one patients with postoperative hypertension after coronary artery bypass graft surgery received iv isradipine, a new dihydropyridine calcium-channel antagonist. Mean duration of the isradipine infusion was 96.9 +/- 29 min. Mean dose of isradipine, indexed to weight, was 16.63 +/- 6.66 micrograms/kg (n = 20). MEASUREMENTS AND MAIN RESULTS: Twenty of the 21 patients achieved satisfactory BP control. The reduction in mean arterial pressure (MAP), first noted at the 15-min point, was maximal at 1 hr when MAP decreased from 102 +/- 9 mm Hg baseline to 81 +/- 5 mm Hg (p less than .01), accompanied by a significant (p less than .01) decrease in systemic vascular resistance from 1753 +/- 339 baseline to 1180 +/- 229 dyne.sec/cm5. The CVP, pulmonary artery diastolic pressure, and pulmonary artery occlusion pressure did not change significantly. Heart rate and cardiac index increased; however, stroke volume index did not change. CONCLUSIONS: Isradipine is an acceptable agent for the treatment of hypertension in this setting.[1]References
- Isradipine for treatment of acute hypertension after myocardial revascularization. Brister, N.W., Barnette, R.E., Schartel, S.A., McClurken, J.B., Alpern, J. Crit. Care Med. (1991) [Pubmed]
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