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document
Comparison of antihypertensives after coronary artery surgery . Hypertension following coronary artery bypass grafting is a common problem that may result in postoperative myocardial infraction or bleeding , Hemodynamic effects were compared in 45 hypertensive coronary bypass patients randomized to receive either diltiazem , nitroglycerin , or sodium nitroprusside . Diltiazem was administered as an intravenous bolus of 0.3 mg.kg-1 within 5 min , followed by infusion of 0.1-0.8 mg.kg-1.h-1 in group 1 . Nitroglycerin was infused at a rate of 1-3 microg.kg.h-1 in group 2 , and sodium nitroprusside was given at a rate of 1-3 microg.kg-1.min-1 in group 3 . Hemodynamic measurements were carried out before infusion ( T1 ) and at 30 min ( T2 ) , 2 h ( T3 ) , and 12 h ( T4 ) after initiation of treatment in the intensive care unit . Mean arterial pressure decreased significantly in all groups . There were no differences among groups at T1 and T2 . At T3 , heart rate in group 2 was significantly higher than group 1 . At T3 and T4 , the double product was highest in group 3 ( group 1 vs. 3 , p < 0.001 ) . These results suggest that the hemodynamic effects of the 3 drugs are similar within the first 30 min . However , after 30 min , diltiazem affords better myocardial performance and more effective control of hypertension .
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Intervention_Pharmacological
antihypertensives
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Intervention_Pharmacological
diltiazem , nitroglycerin , or sodium nitroprusside
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Intervention_Pharmacological
Diltiazem
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Intervention_Pharmacological
Nitroglycerin
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Intervention_Pharmacological
sodium nitroprusside
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Intervention_Pharmacological
diltiazem
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Outcome_Physical
Hypertension
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Outcome_Physical
postoperative myocardial infraction
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Outcome_Physical
bleeding , Hemodynamic effects
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Outcome_Physical
Hemodynamic measurements
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Outcome_Physical
Mean arterial pressure
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Outcome_Physical
heart rate
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Outcome_Physical
hemodynamic effects
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Outcome_Physical
myocardial performance
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Outcome_Physical
hypertension
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Participant_Condition
coronary artery surgery
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Participant_Condition
coronary artery bypass grafting
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Participant_Sample-size
45
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Participant_Condition
hypertensive coronary bypass