J Korean Med Sci.  2012 Sep;27(9):1085-1090. 10.3346/jkms.2012.27.9.1085.

Antihypertensive Treatment of Acute Intracerebral Hemorrhage by Intravenous Nicardipine Hydrochloride: Prospective Multi-Center Study

• Hwang SK
• Kim JS
• Kim JH
• Hong CK
• Yang KH

• KMID: 1782144
• DOI: http://doi.org/10.3346/jkms.2012.27.9.1085

Abstract

The authors performed a multicenter prospective study to evaluate the feasibility and safety of intravenous nicardipine hydrochloride for acute hypertension in patients with intracerebral hemorrhage (ICH). This study included 88 patients (mean age: 58.3 yr, range 26-87 yr) with ICH and acute hypertension in 5 medical centers between August 2008 and November 2010, who were treated using intravenous nicardipine. Administration of nicardipine resulted in a decrease from mean systolic blood pressure (BP) (175.4 +/- 33.7 mmHg) and diastolic BP (100.8 +/- 22 mmHg) at admission to mean systolic BP (127.4 +/- 16.7 mmHg) and diastolic BP (67.2 +/- 12.9 mmHg) in 6 hr after infusion (P < 0.001, mixed-effect linear models). Among patients who underwent follow-up by computed tomography, hematoma expansion at 24 hr (more than 33% increase in hematoma size at 24 hr) was observed in 3 (3.4%) of 88 patients. Neurological deterioration (defined as a decrease in initial Glasgow coma scale > or = 2) was observed in 2 (2.2%) of 88 patients during the treatment. Aggressive nicardipine treatment of acute hypertension in patients with ICH can be safe and effective with a low rate of neurological deterioration and hematoma expansion.

Keyword

Intracerebral Hemorrhage; Hypertension; Nicardipine Hydrochloride; Prospective Studies

MeSH Terms

Acute Disease
Adult
Aged
Aged, 80 and over
Antihypertensive Agents/adverse effects/*therapeutic use
Blood Pressure
Cerebral Hemorrhage/*drug therapy
Cohort Studies
Female
Follow-Up Studies
Glasgow Coma Scale
Hematoma/etiology
Humans
Injections, Intravenous
Male
Middle Aged
Nicardipine/adverse effects/*therapeutic use
Prospective Studies
Tomography, X-Ray Computed
Treatment Outcome
Antihypertensive Agents
Nicardipine

Figure

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  Fig. 1 Antihypertensive management protocol.

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  Fig. 2 Time of onset vs change of BP. (A) Systolic BP. (B) Diastolic BP. Bars indicate standard deviation. Administration of nicardipine by protocol resulted in a decrease in mean SBP/DBP during the first 2 hr after infusion. However, after 2 hr, there were no changes in mean SBP/DBP up to 24 hr.

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