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Urapidil, compared to nitroglycerin, has better clinical safety in the treatment of hypertensive patients with acute heart failure: a meta-analysis

Authors Shi J, Li Y, Xing C, Peng P, Shi H, Ding H, Zheng P, Ning G, Feng S

Received 31 August 2018

Accepted for publication 4 December 2018

Published 27 December 2018 Volume 2019:13 Pages 161—172

DOI https://doi.org/10.2147/DDDT.S185972

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 3

Editor who approved publication: Dr Tuo Deng


Jiaxiao Shi,1,2,* Yulin Li,1,2,* Cong Xing,1,2,* Peng Peng,1,2 Hongyu Shi,1,2 Han Ding,1,2 Pengyuan Zheng,1,2 Guangzhi Ning,1,2 Shiqing Feng1,2

1
Department of Orthopaedics, Tianjin Medical University General Hospital, Heping District, Tianjin 300052, PR China; 2Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Heping District, Tianjin 300052, PR China

*These authors contributed equally to this work

Objectives: The application of urapidil for treating hypertensive patients with acute heart failure in the emergency department remains controversial. Our objective was to organize the relevant articles and assess the clinical indexes between urapidil and nitroglycerin.
Materials and methods: PubMed, EMBASE, the Cochrane Library and China National Knowledge Infrastructure were searched for randomized studies that compared urapidil treatment with nitroglycerin treatment for hypertensive patients with acute heart failure. The risk ratio, with 95% CI, was calculated by using a corresponding effects model, according to the value of I2.
Results: Seven randomized controlled trials were identified, in order to compare the clinical indexes. On comparing the clinical indexes, the urapidil group was found to be better than the nitroglycerin group in regard to left ventricular ejection fraction, systolic blood pressure, N-terminal prohormone of brain natriuretic peptide, left ventricular end-diastolic volume, cardiac index, ALT, AST and health complications (P<0.05), but the indexes of creatinine were worse in the urapidil group. Furthermore, the two methods of treatment were comparable in diastolic blood pressure, left ventricular end-systolic volume, left ventricular end-systolic dimension, heart rate, fasting plasma glucose and total cholesterol levels (P>0.05).
Conclusion: Based on the current evidence, urapidil treatment had better clinical safety features than the traditional pharmaceutical treatment with nitroglycerin. For those indicators with a small amount of data, a greater number of randomized, high-quality controlled trials should be conducted in order to further verify the findings, which could give researchers a more comprehensive evaluation of urapidil treatment.

Keywords: urapidil, nitroglycerin, acute heart failure, meta-analysis

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