Comparative study of isradipine and sodium nitroprusside in the control of hypertension in patients following coronary artery-bypass surgery.

Essential hypertension is a common occurrence after coronary artery bypass-graft surgery. CABG and may lead to postoperative complications. In an open randomized study, either isradipine or sodium nitroprusside was given by infusion to 27 postoperative CABG patients who had a mean arterial pressure (MAP) greater than 100 mmHg. Both agents were able to achieve reductions in MAP to 80-90 mmHg quickly and safely, although the effects of isradipine at the dosage used were apparent sooner and gave smoother control than with sodium nitroprusside. There were two non-responders with the latter agent. Systemic vascular resistance fell and cardiac output increased in patients in both treatment groups. Also, an increase in heart rate was observed with both agents, although this increase was smaller with isradipine. In conclusion, isradipine appears to be a useful agent in the treatment of hypertension following CABG surgery and may have some advantages over sodium nitroprusside.