Limitations of Urapidil Use in Acute Cerebrovascular Disease (Review of Literature and Own Observations)

V.V. Nikonov, I. B. Savytska

Abstract


The overwhelming number of patients with acute cerebrovascular disease (ACD) has arterial hypertension. The routine blood pressure (BP) reduction is not recommended in the acute period of acute cerebrovascular disease. Emergency antihypertensive therapy is indicated when BP increases up to 220/120 mm Hg, it should be used carefully if ACD is combined with heart failure, aortic dissection, acute myocardial infarction, acute renal failure, if there is a the need for thrombolysis. The drug of choice in the acute period of ACD is urapidil, injection and encapsulated form. Urapidil is an effective and safe drug of antihypertensive therapy in acute cerebrovascular disease. It causes a more rapid and persistent decrease in systolic and diastolic BP in the absence of compensatory tachycardia. Urapidil improves the emotional state of patients, there is a high compliance to therapy.


Keywords


acute cerebrovascular disease; antihypertensive therapy; urapidil

References


Hoedt-Rasmussen K., Skinhoj E., Paulson O. et al. Regional cerebral blood flow in acute apoplexy: The luxury perfusion syndrome of brain tissue // Arch. Neurol. — 1967. — Vol. 17. — P. 271-281.

Dawson S.L., Blake M.J., Panerai R.B., Potter J.F. Dynamic but not static cerebral autoregulation is impaired in acute ischaemic stroke // Cerebrovasc. Dis. — 2000. — Vol. 10. — P. 126-132.

Eames P.J., Blake M.J., Dawson S.L. et al. Dynamic cerebral autoregulation and beat to beat blood pressure control are impaired in acute ischaemic stroke // J. Neurol. Neurosurg. Psychiatry. — 2002. — Vol. 72. — P. 467-472.

Britton M., Carlsson A., De Faire U. Blood pressure course in patients with acute stroke and matched controls // Stroke. — 1986. — Vol. 17. — P. 861-864.

Harper G., Castleden C.M., Potter J.F. Factors affecting changes in blood pressure after acute stroke // Stroke. — 1994. — Vol. 25. — P. 1726-1729.

The European Stroke Initiative Executive Committee and the EUSI Writing Committee. European Stroke Initiative recommendations for stroke management: Update 2003 // Cerebrovasc. Dis. — 2003. — Vol. 16. — P. 311-337.

Anderson C.S. et al. Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial // Lancet Neurol. — 2008. — Vol. 7. — 391-399.

National Heart Foundation of Australia (National Blood Pressure and Vascular Disease Advisory Committee). Guide to management of hypertension 2008. Updated August 2009.

Rosei E.A., Salvetti M. Treatment of hypertensive urgencies and emergencies // European Society of Hypertension Scientific Newsletters: Update on Hypertension Management. — 2006. — P. 7-28.

Spah F., Grosser K.D., Thieme G. Acute haemodynamic effects of urapidil and nifedipine in hypertensive urgencies and emergencies // Drugs. — 1990. — 40 (Suppl. 4). — 58-59.

The European Stroke Initiative Executive Committee // Cerebrovascular Dis. — 2003. — 16. — 311-337.

Castillo J., Leira R., Garcia M.M. et al. Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome // Stroke. — 2004. — Vol. 35. — P. 520-527.

Денисюк В.І. Гіпертонічні кризи: стандарти діагностики, надання невідкладної допомоги та профілактика // Артериальная гипертензия. — 2010. — № 2. — С. 42-47.

Иркин О.И. Современная тактика лечения больных с гипертензивными кризами // Медицина неотложных состояний. — 2010. — № 2. — С. 23-25.

AHA/ASA Guidelines for the Early Management of Adults With Ischemic Stroke // Stroke. — 2007. — Vol. 38. — P. 1655-1711.

European Stroke Initiative Recommendations for Stroke Mana­gement — Uрdate 2003 // Cerebrovasc. Dis. — 2003. — № 16. — P. 311-337.

Коваль Е.А., Михайличенко Д.С., Павленко А.Н., Пешехонова О.Н. и др. Эффективность и безопасность урапидила у пациентов с гипертоническими кризами, осложненными острым нарушением мозгового кровообращения // Медицина неотложных состояний. — 2012. — № 1.




DOI: https://doi.org/10.22141/2224-0586.1.72.2016.74447

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