Clevidipine 25mg/50ml emulsion for infusion vials

A hypertensive crisis is defined as a sudden and significant rise in blood pressure. The blood pressure reading is 180/120 mmHg or higher. A hypertensive crisis is a medical emergency. It can lead to a heart attack, stroke, or other life-threatening medical problems. Investigating the management of the hypertensive crisis was the goal of this study. English-language articles were collected from 2010 to 2024 demonstrating the management of the hypertensive crisis. Overall, there were 15 articles. Surveys and analyses of national databases were the most widely used methods (n=15). The scientific studies documented (1) all investigative studies or reports that included a hypertensive crisis diagnosis, (2) data integrity and reproducibility, and (3) management studies. Other studies show that acute severe hypertension in the hospital is associated with high rates of mortality and morbidity, particularly with new or worsening end-organ damage. The problem is linked to poor medical adherence, but alarmingly low follow-up rates are likely to contribute to a high recurrence rate. The treatment of acute severe hypertension varies according to the hospital unit (medical ward or intensive care unit), medication, and blood pressure targets or thresholds. Because of a lack of evidence-based guidance, arbitrary blood pressure control targets are used, or blood pressure targets are crudely extrapolated from guidelines intended primarily for outpatient management. Patients with acute aortic dissection need to be administered intravenous esmolol within 5 to 10 minutes in order to lower their blood pressure right away. The goal is to maintain a systolic reading of less than 120 mm Hg. Vasodilators such as nitroglycerin or nitroprusside may be administered if the blood pressure persists following beta blocking. Intravenous administration of clevidipine, nicardipine, or phentolamine is required; the initial dose is 5 mg, with subsequent doses given every 10 minutes as necessary to achieve the desired reduction in blood pressure.

Abstract licence: CC BY

Abstract Background: The term "cerebrovascular diseases (CVDs)" refers to a broad category of diseases that affect the brain's blood vessels and cerebral circulation. According to a substantial body of evidence, controlling acute hypertension (HTN) by antihypertensive drugs such as clevidipine and nicardipine can be a highly efficient method of lowering the incidence of CVDs. The aim of this systematic review and meta-analysis is to compare and analyze the outcomes of clevidipine and nicardipine in CVD patients for the first time. Methods: For identifying potential eligible studies, two independent researchers systematically searched PubMed, Scopus, and Web of Science online databases, and the gray literature search, including Google scholar and hand-searching, were performed. Included studies were any observational (Retrospective/prospective cohort and cross-sectional) literature that compares adult patients receiving clevidipine or nicardipine for controlling HTN in the setting of CVD. Results: We reviewed 487 articles and finally included 5 studies, including 546 patients (211 received clevidipine, and 335 received nicardipine). The pooled standardized mean difference (SMD) for time to goal SBP was -0.04 (95% CI: [-0.66; 0.58], p-value: 0.86, I2: 79.0%, pooled MD: -12.90 min), meaning that the clevidipine group has shorter time to goal systolic blood pressure (SBP) compared to nicardipine. The pooled SMD for total volume infusion was -0.52 (95% CI: [-0.93; -0.12], p-value: 0.03, I2: 0.0%, pooled MD: -1118.81 mL), showing a notable less total volume infused to patients in the clevidipine group. Conclusion: We found that clevidipine reaches the SBP goal faster than nicardipine; however, there is no statistically significant difference between the two drugs. The total volume infused to achieve the goal SBP is significantly less in the clevidipine group. Both clevidipine and nicardipine are safe, and their adverse effects are comparable. Further prospective studies in a blinded and protocolized condition are needed to compare clevidipine and nicardipine in CVD patients on a large scale.

Abstract licence: CC BY 4.0