Hypotension and coronary events on nifedipine: reassessing nifedipine safety

Nifedipine administration for hypertensive emergencies can induce neurological and cardiac events due to abrupt hypotension. Nifedipine also increase the risk of coronary events in case of unstable angina or recent myocardial infarction. In hypertensive emergencies, the potential advantages and risks of achieving a rapid fall in arterial pressure should be assessed case by case. In patients with coronary heart disease, nifedipine is contraindicated in case of recent myocardial infarction or unstable angina. Nifedipine is only a second-line choice for stable angina, and should be combined with a betablocker.