enalaprilat-anhydrous and clevidipine

Hypertensive emergency is defined as a systolic blood pressure > 180 mmHg or a diastolic blood pressure > 120 mmHg with evidence of new or progressive end-organ damage. The purpose of this paper is to review advances in the treatment of hypertensive emergencies within the last 5 years.. New literature and recommendations for managing hypertensive emergencies in the setting of pregnancy, stroke, and heart failure have been published. Oral nifedipine is now considered an alternative first-line therapy, along with intravenous hydralazine and labetalol for women presenting with pre-eclampsia. Clevidipine is now endorsed by guidelines as a first-line treatment option for blood pressure reduction in acute ischemic stroke and may be considered for use in intracranial hemorrhage. Treatment of hypertensive heart failure remains challenging; clevidipine and enalaprilat can be considered for use in this population although data supporting their use remains limited.

Topics: Administration, Oral; Antihypertensive Agents; Blood Pressure; Brain Ischemia; Emergencies; Enalaprilat; Female; Guideline Adherence; Heart Failure; Humans; Hydralazine; Hypertension; Infusions, Intravenous; Intracranial Hemorrhages; Labetalol; Nifedipine; Pre-Eclampsia; Pregnancy; Pyridines; Stroke

Perioperative hypertension is commonly encountered in patients that undergo surgery. While attempts have been made to standardize the method to characterize the intraoperative hemodynamics, these methods still vary widely. In addition, there is a lack of consensus concerning treatment thresholds and appropriate therapeutic targets, making absolute recommendations about treatment difficult. Nevertheless, perioperative hypertension requires careful management. When treatment is necessary, therapy should be individualized for the patient. This paper reviews the pharmacologic agents and strategies commonly used in the management of perioperative hypertension.

Topics: Adrenergic beta-Antagonists; Antihypertensive Agents; Enalaprilat; Fenoldopam; Hemodynamics; Humans; Hydralazine; Hypertension; Incidence; Labetalol; Nicardipine; Nitroglycerin; Nitroprusside; Perioperative Care; Postoperative Complications; Propanolamines; Pyridines; Surgical Procedures, Operative; Vascular Resistance; Vasodilator Agents