Safety and Efficacy of Short-Acting Sublingual Nifedipine in the Treatment of Systemic Hypertension in Patients With Elevated Intracranial Pressur

Abstract

PURPOSE: Intracranial disease with increased intracranial pressure (ICP) is often attended by systemic hypertension, which must be controlled. Many antihypertensive medications have side effects (e.g. increased ICP with many vasodilators and bradycardia with beta blockers) which limit their utility in this setting. Sublingual nifedipine has no such side effects, and has long been used in our medical intensive care unit (MICU) for the treatment of arterial hypertension accompanying elevated ICP. Recent reports of hypotension associated with the use of sublingual nifedipine have caused its safety to be questioned. We report our experience of the last 15 years with short acting nifedipine in this setting.