A systematic review of nicardipine vs labetalol for the management of hypertensive crises

W. Frank Peacock IV, Daniel E. Hilleman, Phillip D. Levy, Denise H. Rhoney, Joseph Varon

Research output: Contribution to journalReview article

34 Scopus citations

Abstract

Hypertensive emergencies are acute elevations in blood pressure (BP) that occur in the presence of progressive end-organ damage. Hypertensive urgencies, defined as elevated BP without acute end-organ damage, can often be treated with oral agents, whereas hypertensive emergencies are best treated with intravenous titratable agents. However, a lack of head-to-head studies has made it difficult to establish which intravenous drug is most effective in treating hypertensive crises. This systematic review presents a synthesis of published studies that compare the antihypertensive agents nicardipine and labetalol in patients experiencing acute hypertensive crises. A MEDLINE search was conducted using the term labetalol AND nicardipine AND hypertension. Conference abstracts were searched manually. Ultimately, 10 studies were included, encompassing patients with hypertensive crises across an array of indications and practice environments (stroke, the emergency department, critical care, surgery, pediatrics, and pregnancy). The results of this systematic review show comparable efficacy and safety for nicardipine and labetalol, although nicardipine appears to provide more predictable and consistent BP control than labetalol.

Original languageEnglish (US)
Pages (from-to)981-993
Number of pages13
JournalAmerican Journal of Emergency Medicine
Volume30
Issue number6
DOIs
StatePublished - Jul 1 2012

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All Science Journal Classification (ASJC) codes

  • Emergency Medicine

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