Tulman David B, Stawicki Stanislaw P A, Papadimos Thomas J, Murphy Claire V, Bergese Sergio D
Department of Anesthesiology, The Ohio State University School of Medicine, Columbus, Ohio 43210, USA.
Discov Med. 2012 May;13(72):375-83.
Chronic hypertension affects >1 billion people worldwide and >70 million people in the United States. Acute hypertensive episodes (AHE) are defined as severe spikes in blood pressure that may result in end-organ damage. Although AHE may arise independently as de novo events, they are more likely to occur in patients with pre-existing hypertension. One of the controversies regarding the clinical approach to AHE is the selection of anti-hypertensive medication. Depending on the clinical presentation of the patient and the threat of end-organ damage resulting from blood pressure elevation, appropriate and prompt treatment is warranted. There are multiple agents available for the management of hypertension. However, the greatest challenge lies in the acute care setting where the need exists for better initial and sustained control of blood pressure spikes. Many anti-hypertensive agents effectively lower blood pressure, yet only few have the capacity to achieve strict control of hypertension in the acute setting. Clevidipine butyrate is an ultra short-acting intravenous dihydropyridine calcium-channel blocker. Clevidipine has unique pharmacodynamic and pharmacokinetic properties that enable the fast, safe, and adequate reduction of blood pressure in hypertensive emergencies, with the ability to provide highly precise titration necessary to maintain a narrowly-defined target blood pressure range. Several recently published phase I, II, and III clinical studies have shown Clevidipine to be an effective blood pressure modulator in such capacity.
全球有超过10亿人患有慢性高血压，美国有超过7000万人患病。急性高血压发作（AHE）被定义为血压严重飙升，可能导致终末器官损伤。虽然AHE可能作为新发事件独立出现，但它们更有可能发生在已有高血压的患者身上。关于AHE临床治疗方法的争议之一是抗高血压药物的选择。根据患者的临床表现以及血压升高导致的终末器官损伤风险，需要进行适当且及时的治疗。有多种药物可用于治疗高血压。然而，最大的挑战在于急性护理环境，在这种情况下需要更好地初始控制和持续控制血压飙升。许多抗高血压药物能有效降低血压，但只有少数药物有能力在急性情况下实现对高血压的严格控制。丁酸氯维地平是一种超短效静脉注射二氢吡啶类钙通道阻滞剂。氯维地平具有独特的药效学和药代动力学特性，能够在高血压急症中快速、安全且充分地降低血压，并能够提供维持狭窄定义的目标血压范围所需的高度精确滴定。最近发表的几项I期、II期和III期临床研究表明，氯维地平在这种情况下是一种有效的血压调节剂。
