Is there a preference among antihypertensive for hypertension during tPA infusion?

Comment by InpharmD Researcher

There does not appear to be a preferred antihypertensive agent for the management of hypertension during tPA infusion. According to AHA/ASA guidelines, the same recommended agents used to lower the blood pressure prior to IV tPA administration should be used to maintain blood pressure during infusion (i.e., labetalol, nicardipine, clevidipine, hydralazine, enalaprilat, or sodium nitroprusside). Generally, nicardipine, labetalol, and clevidipine are preferred to other agents due to easy titration, predictive blood pressure control, and neutral effects on intracranial pathology. The choice of agent should depend on patient-specific factors such as potential comorbidities, heart rate, and volume status (see Table 1). Nicardipine may provide faster and more controlled blood pressure reduction than labetalol but is similar in efficacy to clevidipine.

Background

According to 2019 and 2018 American Heart Association (AHA)/American Stroke Association (ASA) guidelines for the management of patients with acute ischemic stroke, it is recommended to maintain blood pressure at ≤ 180/105 mm Hg during and after alteplase or other acute reperfusion therapy. Blood pressure measurements and neurological assessments should be conducted every 15 minutes during and after intravenous (IV) alteplase infusion for 2 hours, then every 30 minutes for 6 hours, then hourly until 24 hours after IV alteplase treatment. The frequency of blood pressure measurements should be increased if systolic blood pressure is > 180 mm Hg or if diastolic blood pressure is > 105 mm Hg, and antihypertensive medications should be administered to maintain the blood pressure at or below these levels using the same recommended agents that are used to lower the blood pressure prior to IV alteplase administration. A list of these agents with their respective dosing recommendations is provided in Table 1; labetalol, nicardipine, or clevidipine are recommended, and other agents, including hydralazine and enalaprilat, may also be considered. There does not appear to be a preference for one agent over the other. If the patient develops severe headache, acute hypertension, nausea, or vomiting or has a worsening neurological examination, the IV alteplase infusion should be discontinued, and an emergency head computed tomography (CT) scan should be obtained. [1], [2]

A 2019 review discusses blood pressure management during and after recanalization therapy for acute ischemic stroke. In general, agents with a fast onset of action and short duration are preferable in the acute setting to rapidly achieve hemodynamic goals and avoid prolonged periods of hypotension. Each agent has various contraindications and may be useful in specific clinical scenarios based on patients' comorbidities. Agents recommended for blood pressure-lowering during and after recanalization therapy for acute ischemic stroke include labetalol, hydralazine, enalaprilat, nicardipine, clevidipine, sodium nitroprusside, or nitroglycerin (see Table 1 for respective dosing and administration recommendations, pharmacokinetics, and clinical pearls). [3]

Labetalol, which has negative chronotropic effects, may limit its utility in patients with significant bradycardia. However, it is a suitable agent for patients with acute ischemic stroke or other intracranial pathology, given its minimal impact on either cerebral blood flow or oxygen consumption. Nicardipine allows for a faster and more controlled reduction in blood pressure with significantly less variability compared to labetalol; however, head-to-head studies have found no differences in clinical outcomes between the two agents and the cost associated with nicardipine therapy is substantially higher. Like nicardipine, clevidipine generally does not decrease heart rate and has similar efficacy in lowering blood pressure. As less volume is required for clevidipine administration, it may be optimal in patients with volume overload. Since clevidipine is formulated in a lipid emulsion, there is an inherent risk of hypertriglyceridemia and pancreatitis, and the maximum daily dose is 1,000 mL (or approximately 21 mg/hour/day). [3]

Despite hydralazine's effectiveness in lowering blood pressure, it can increase intracranial pressure while simultaneously reducing mean arterial pressure, leading to decreased perfusion pressure and increasing the risk of ischemia. Additionally, hydralazine has a prolonged and often unpredictable effect on blood pressure, leading to steep drops in pressure and significant variability. Therefore, hydralazine is less preferred in acute ischemic stroke but can be considered when other agents are unavailable. Angiotensin-converting enzyme inhibitors such as enalaprilat are thought to be neutral for intracranial pressure, making it a potential option in patients with intracranial pathology; however, its long duration of action (i.e., 12-24 hours) limits the ability to titrate the agent to specific blood pressure goals. Additionally, there is an increased risk of orolingual angioedema during alteplase administration. [3]

Due to the vasodilatory effects on cerebral vasculature with sodium nitroprusside, increased intracranial pressure can occur in patients with impaired autoregulation. Sodium nitroprusside also contains cyanide, which can accumulate and lead to toxicity. Patients at risk for cyanide toxicity include those with hypoalbuminemia or those undergoing cardiopulmonary bypass. Despite its potent anti-hypertensive properties, sodium nitroprusside is a less ideal agent for use in acute ischemic stroke due to its potential for impacting cerebral blood volume and intracranial pressure. However, it can be considered in cases where other agents are not available or are contraindicated due to patient-specific characteristics. Nitroglycerin has been found to be effective in lowering blood pressure but not functional outcomes in acute ischemic stroke, but similar to sodium nitroprusside, it may increase intracranial pressure based on limited observational studies. In accordance with guideline recommendations, the authors appear to prefer nicardipine, labetalol, or clevidipine over other recommended agents, such as hydralazine, enalaprilat, sodium nitroprusside, or nitroglycerine for blood pressure management during and after recanalization with alteplase, but the preferred agent should depend on patient-specific factors and comorbidities. [3]

A 2014 review discusses blood pressure management in acute ischemic stroke and intracerebral hemorrhage. Blood pressure agents should be rapid-acting, easily titrated, and have few side effects and short half-lives. Commonly used IV medications include nicardipine, labetalol, sodium nitroprusside, nitroglycerin, enalaprilat, and hydralazine. Due to the unpredictable dose-response relationship, risk of rebound hypertension, possibility of cyanide toxicity during prolonged use, and potential to cause raised intracranial pressure, sodium nitroprusside may not be ideal for acute reduction of blood pressure. Additionally, while hydralazine is used frequently for acute reduction of BP, its use in routine clinical practice is limited due to its selective arteriolar vasodilator effect, resulting in reflex tachycardia leading to myocardial injury. Data comparing the therapeutic response and tolerability of labetalol boluses versus IV nicardipine infusion in the acute stroke setting demonstrated a higher proportion of patients receiving nicardipine achieved goal blood pressure within 60 minutes of treatment initiation (100% vs. 61%; p<0.001) and spent a greater amount of time in the goal blood pressure range compared to the labetalol group. Additionally, the number of dose adjustments required to reach goal blood pressure was lower (0 vs. 2, p<0.001) in the nicardipine group, which indicates a reliable dose-response. [4], [5]

Three retrospective cohort studies compared clevidipine and nicardipine for acute blood pressure reduction in patients with stroke, including both ischemic and hemorrhagic strokes. Time to achieve blood pressure goal, which was the primary outcome across all three studies, was not significantly different between nicardipine- and clevidipine-treated groups. Other efficacy and safety outcomes were similar between the two agents, except that in one study, clevidipine administration resulted in significantly less volume administered per patient versus nicardipine. Overall, both agents are reasonable options for blood pressure management during acute stroke, even though cost and volume restriction could differentiate preference. Results from retrospective studies need to be interpreted with caution, as confounding factors, such as inconsistent charting of blood pressure during an emergency, cannot be completely ruled out. [6], [7], [8]

References:

[1] Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2019 Dec;50(12):e440-e441]. Stroke. 2019;50(12):e344-e418. doi:10.1161/STR.0000000000000211
[2] Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2018 Mar;49(3):e138] [published correction appears in Stroke. 2018 Apr 18;:]. Stroke. 2018;49(3):e46-e110. doi:10.1161/STR.0000000000000158
[3] Vitt JR, Trillanes M, Hemphill JC 3rd. Management of Blood Pressure During and After Recanalization Therapy for Acute Ischemic Stroke. Front Neurol. 2019;10:138. Published 2019 Feb 21. doi:10.3389/fneur.2019.00138
[4] Bowry R, Navalkele DD, Gonzales NR. Blood pressure management in stroke: Five new things. Neurol Clin Pract. 2014;4(5):419-426. doi:10.1212/CPJ.0000000000000085
[5] Liu-DeRyke X, Levy PD, Parker D Jr, Coplin W, Rhoney DH. A prospective evaluation of labetalol versus nicardipine for blood pressure management in patients with acute stroke. Neurocrit Care. 2013;19(1):41-47. doi:10.1007/s12028-013-9863-9
[6] Allison TA, Bowman S, Gulbis B, Hartman H, Schepcoff S, Lee K. Comparison of Clevidipine and Nicardipine for Acute Blood Pressure Reduction in Patients With Stroke. J Intensive Care Med. 2019;34(11-12):990-995. doi:10.1177/0885066617724340
[7] Rosenfeldt Z, Conklen K, Jones B, Ferrill D, Deshpande M, Siddiqui FM. Comparison of Nicardipine with Clevidipine in the Management of Hypertension in Acute Cerebrovascular Diseases. J Stroke Cerebrovasc Dis. 2018;27(8):2067-2073. doi:10.1016/j.jstrokecerebrovasdis.2018.03.001
[8] Finger JR, Kurczewski LM, Brophy GM. Clevidipine Versus Nicardipine for Acute Blood Pressure Reduction in a Neuroscience Intensive Care Population. Neurocrit Care. 2017;26(2):167-173. doi:10.1007/s12028-016-0349-4

Literature Review

A search of the published medical literature revealed 1 study investigating the researchable question:

Is there a preference among antihypertensive for hypertension during tPA infusion?

Level of evidence

X - No data  Read more→



Please see Table 1 for your response.


Options to Treat Arterial Hypertension in Patients with AIS Who Are Candidates for Acute Reperfusion Therapy*

Patients otherwise eligible for acute reperfusion therapy except that BP is >185/110 mm Hg:

Labetalol 10-20 mg IV over 1-2 minutes, may repeat 1 time; or

Nicardipine 5 mg/hour IV, titrate up by 2.5 mg/hour every 5-15 minutes, maximum 15 mg/hour; when desired BP reached, adjust to maintain proper BP limits; or

Clevidipine 1-2 mg/hour IV, titrate by doubling the dose every 2-5 minutes until desired BP reached; maximum 21 mg/hour

Other agents (e.g., hydralazine, enalaprilat) may also be considered

If BP is not maintained ≤ 185/110 mm Hg, do not administer alteplase

Management of BP during and after alteplase or other acute reperfusion therapy to maintain BP ≤ 180/105 mm Hg:

Monitor BP every 15 minutes for  hours from the start of alteplase therapy, then every 30 minutes for 6 hours, and then every hour for 16 hours

If systolic BP > 180-230 mm Hg or diastolic BP > 105-120 mm Hg:

Labetalol 10 mg IV followed by continuous IV infusion 2-8 mg/minute; or

Nicardipine 5 mg/hour IV, titrate up to desired effect by 2.5 mg/hour every 5-15 minutes, maximum 15 mg/hour; or

Clevidipine 1-2 mg/hour IV, titrate by doubling the dose every 2-5 minutes until desired BP reached; maximum 21 mg/hour

If BP not controlled or diastolic BP > 140 mm Hg, consider IV sodium nitroprusside

*Different treatment options may be appropriate in patients who have comorbid conditions that may benefit from acute reductions in BP such as acute coronary event, acute heart failure, aortic dissection, or preeclampsia/eclampsia.

AIS, acute ischemic stroke; BP, blood pressure; IV, intravenous

Agent

Onset of action, minutes

Duration Clinical Pearls

Labetalol

2-5

2-4 hours

Bradycardia

Contraindicated in > 1st degree heart block and cardiogenic shock

Hydralazine

10-20 Up to 12 hours

Tachycardia

Drug-induced lupus erythematosus

Increased intracranial pressure

Enalaprilat

< 15 Up to 6 hours

Contraindicated in patients with history of angioedema related to an angiotensin converting enzyme inhibitor

Caution in bilateral renal artery stenosis

Caution in hypovolemia

Nicardipine

5-15 4-6 hours

Contraindicated in advanced aortic stenosis

Clevidipine

2-4 5-15 minutes

Hypertriglyceridemia

Contains soy

Avoid in patients with defective lipid metabolism

Limited data with use > 72 hours

Sodium nitroprusside

1-2 2-3 minutes

Cyanide toxicity

Increased intracranial pressure

Nitroglycerin

30-60 Duration of application, typically 12-14 hours

Contraindicated with phosphodiesterase-5 inhibitor

Tachyphylaxis

Possible increase in intracranial pressure

References:

Adapted from:
[1] Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2019 Dec;50(12):e440-e441]. Stroke. 2019;50(12):e344-e418. doi:10.1161/STR.0000000000000211
[2] Powers WJ, Rabinstein AA, Ackerson T, et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [published correction appears in Stroke. 2018 Mar;49(3):e138] [published correction appears in Stroke. 2018 Apr 18;:]. Stroke. 2018;49(3):e46-e110. doi:10.1161/STR.0000000000000158
[3] Vitt JR, Trillanes M, Hemphill JC 3rd. Management of Blood Pressure During and After Recanalization Therapy for Acute Ischemic Stroke. Front Neurol. 2019;10:138. Published 2019 Feb 21. doi:10.3389/fneur.2019.00138