Beschreibung:
Thirty‐three patients with severe systemic hypertension defined as a diastolic blood pressure (DBP) ≥ 120 mm Hg were randomized in a single‐blind fashion to be treated with either intravenous fenoldopam mesylate (FNP) or sodium nitroprusside (NTP). Fenoldopam mesylate and NTP infusion rates began at 0.1 μg/kg/minute and 0.5 μg/kg/minute, respectively and were titrated to achieve a goal DBP of between 95 and 110 mm Hg; or a reduction of at least 40 mm Hg if the baseline DBP was > 150 mm Hg. Fenoldopam mesylate (n = 15) reduced blood pressure from 217/145 ± 6/5 to 187/112 ± 6/3 mm Hg (P < .001) at an average infusion rate of 0.5 ± 0.1 μg/kg/minute. The average time to achieve goal DBP with FNP was 1.5 ± 1.4 hours. Nitroprusside (n = 18) reduced blood pressure from 210/136 ± 5/2 to 172/103 ± 6/2 mm Hg (P < .001) at an average infusion rate of 1.2 ± .24 μg/kg/minute. Nitroprusside response time averaged 2 ± 2.5 hours. There was no significant difference between the magnitude of effect seen with either FNP or NTP; nor was there any difference observed in the adverse effect rates of the two agents. Fenoldopam mesylate and NTP demonstrate similar overall efficacy in the treatment of severe systemic hypertension.