CHSU Discovery

A hypertensive crisis is defined as an acute, marked elevation in blood pressure (≥ 180/120 mmHg) associated with (emergency) or without (urgency) acute target organ damage.

Examples of hypertensive emergencies include:encephalopathy, stroke, aortic dissection, acute coronary syndrome, and pulmonary edema.

Nicardipine, a dihydropyridine calcium channel blocker (CCB), is commonly used in all hypertensive crises, except those involving cardiac contractility defects due to concerns of it reducing contractility and cardiac output as seen with non-dihydropyridine CCB (i.e.diltiazem).

However, dihydropyridine CCB display greater selectivity for calcium channels in vascular smooth muscle cells and possess minimal myocardial depressant activity.

Of the dihydropyridine CCB available, amlodipine, is recognized as a treatment option for managing chronic hypertension.

In comparison to amlodipine, nicardipine displays greater vascular selectivity, suggesting it too can be used in patients with reduced ejection fractions, but this finding is not substantiated in the literature.

The purpose of this study was to evaluate the utility of nicardipine in adults with reduced ejection fractions experiencing a hypertensive crisis.