Comparative effectiveness of hypertensive crise management in the post-surgery period after carotid endarterectomy: first results

Abstract

Aim. To compare the effectiveness of different antihypertensive medications in the management of hypertensive crise (HC) in the early post-surgery period after carotid endarterectomy (CEE). Material and methods. The study included 39 patients (14 women, 25 men; mean age 65,6±6,6 years) hospitalised to the Cardiovascular Surgery Department of a major Moscow City hospital. All patients underwent CEE, with a HC developed in the early post-surgery period. All participants were divided into three groups: in Group I, HC was treated with nimodipine, while Groups II and III received enalaprilat and uradipil, respectively. Results. Intravenous administration of all three medications resulted in an antihypertensive effect. A significant reduction in blood pressure (BP) levels was observed after the administration of nimodipine and uradipil. However, nimodipine caused reflectory tachycardia, which was not observed in patients treated with uradipil. Conclusion. The results obtained are consistent that out of the three studied medications, uradipil appeared the most appropriate for the HC management in the early post-CEE period. It reduced BP levels without causing reflectory tachycardia or clinical hypotension, which confirms clinical effectiveness and safety of uradipil as a medication of choice for the urgent HC management.

Keywords

• cerebrovascular disease
• atherosclerosis
• carotid endarterectomy
• hypertensive crise
• uradipil
• nimodipine
• enalaprilat