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Comparison of antihypertensives after coronary artery surgery

Fevzi Toraman1, Hasan Karabulut, Onur Goksel

  • 1Department of Cardiovascular Anesthesiology, Acibadem Hospital, Istanbul, Turkey.

Asian Cardiovascular & Thoracic Annals
|November 24, 2005
PubMed

Insights

Diltiazem, nitroglycerin, and sodium nitroprusside all effectively lower blood pressure post-coronary artery bypass grafting. Diltiazem demonstrates superior myocardial performance and hypertension control after 30 minutes.

Area of Science:

  • Cardiovascular Surgery
  • Anesthesiology
  • Pharmacology

Background:

  • Postoperative hypertension is a frequent complication after coronary artery bypass grafting (CABG).
  • This condition increases the risk of adverse events such as myocardial infarction and bleeding.

Purpose of the Study:

  • To compare the hemodynamic effects of diltiazem, nitroglycerin, and sodium nitroprusside in hypertensive patients undergoing CABG.
  • To determine the optimal agent for managing hypertension in the early postoperative period.

Main Methods:

  • Forty-five hypertensive CABG patients were randomized into three groups receiving diltiazem, nitroglycerin, or sodium nitroprusside.
  • Hemodynamic parameters were measured at baseline and at 30 minutes, 2 hours, and 12 hours post-infusion.

Main Results:

  • All agents significantly reduced mean arterial pressure.
  • No significant differences in hemodynamic effects were observed within the first 30 minutes.
  • After 30 minutes, diltiazem showed improved myocardial performance and more effective hypertension control compared to sodium nitroprusside.

Conclusions:

  • Diltiazem offers superior myocardial performance and hypertension management compared to nitroglycerin and sodium nitroprusside in the early hours after CABG.
  • Early hemodynamic effects of these agents are comparable, but diltiazem provides sustained benefits.

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