Article Instance
API Endpoint for journals.
GET /api/articles/8467/?format=api
{ "pk": 8467, "title": "Characteristics of Patients That Do Not Initially Respond to Intravenous Antihypertensives in the Emergency Department: Subanalysis of the CLUE Trial", "subtitle": null, "abstract": "Introduction: \nHypertensive emergency has a high mortality risk and the treatment goal is to quicklylower blood pressure with intravenous (IV) medications. Characteristics that are associated withnon-response to IV antihypertensives have not been identified. The objective is to identify patientcharacteristics associated with resistance to IV antihypertensives.\nMethods: \nThis was a subanalysis of patients enrolled in the previously described comparativeeffectiveness trial of IV nicardipine vs. labetalol use in the emergency department (CLUE) study, arandomized trial of nicardipine vs. labetalol. Non-responders were defined as those patients whodid not achieve target systolic blood pressure (SBP), as set by the treating physician, within thirtyminutes of IV antihypertensive medication, +/- 20mmHg. Stepwise logistic regression was used toidentify covariates associated with the measurement outcomes.\nResults: \nCLUE enrolled 226 patients, 52.7% female, 76.4% black, mean age of 52.6±14.6 years,of whom 110 were treated with nicardipine and 116 with labetalol. The median (IQR) initial systolicblood pressure was 211mmHg (198, 226), 210 (200, 230), and 211mmHg (198,226), for the total,non-responder, and responder cohorts, respectively (p-value=0.65, 95% CI [-5.8-11.3]). Twentyninewere non-responders, 9 in the nicardipine and 20 in the labetalol group. In univariate analysis,several symptoms suggestive of end organ damage were associated with non-response. Aftermultiple variable logistic regression (AUC = 0.72), treatment with labetalol (OR 2.7, 95% CI [1.1-6.7]), history of stroke (OR 5.4, 95% CI [1.6-18.5]), and being male (OR 3.3, 95% CI [1.4-8.1]) wereassociated with failure to achieve target blood pressure.\nConclusion: \nMale gender and history of previous stroke are associated with difficult to controlblood pressure. [West J Emerg Med. 2015;16(2):276–283.]", "language": "en", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "hypertension, emergency medicine, malignant, labetalol, nicardepine" } ], "section": "Health Outcomes", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/5cf8j5p2", "frozenauthors": [ { "first_name": "Caroline", "middle_name": "E.", "last_name": "Freiermuth", "name_suffix": "", "institution": "Duke University Medical Center, Division of Emergency Medicine Durham, North Carolina", "department": "None" }, { "first_name": "Abhinav", "middle_name": "", "last_name": "Chandra", "name_suffix": "", "institution": "Kaiser Permanente, South Sacramento, Sacramento, California", "department": "None" }, { "first_name": "W.", "middle_name": "Frank", "last_name": "Peacock", "name_suffix": "", "institution": "Baylor College of Medicine, Department of Emergency Medicine, Houston, Texas", "department": "None" }, { "first_name": "Alexander", "middle_name": "T.", "last_name": "Limkakeng, Jr.", "name_suffix": "", "institution": "Duke University Medical Center, Division of Emergency Medicine Durham, North Carolina", "department": "None" }, { "first_name": "Joseph", "middle_name": "", "last_name": "Varon", "name_suffix": "", "institution": "The University of Texas Health Science Center at Houston and The University of Texas Medical Branch at Galveston, Houston, Texas", "department": "None" }, { "first_name": "Brigitte", "middle_name": "M.", "last_name": "Baumann", "name_suffix": "", "institution": "Cooper Medical School of Rowan University, Department of Emergency Medicine, Camden, New Jersey", "department": "None" }, { "first_name": "Pierre", "middle_name": "", "last_name": "Borczuk", "name_suffix": "", "institution": "Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "None" }, { "first_name": "Chad", "middle_name": "M.", "last_name": "Cannon", "name_suffix": "", "institution": "University of Kansas Hospital, Department of Emergency Medicine, Kansas City, Kansas", "department": "None" }, { "first_name": "David", "middle_name": "M.", "last_name": "Cline", "name_suffix": "", "institution": "Wake Forest University School of Medicine, Winston-Salem, North Carolina", "department": "None" }, { "first_name": "Deborah", "middle_name": "B.", "last_name": "Diercks", "name_suffix": "", "institution": "University of California, Davis Medical Center, Department of Emergency Medicine, Sacramento, California", "department": "None" }, { "first_name": "Brian", "middle_name": "", "last_name": "Hiestand", "name_suffix": "", "institution": "Wake Forest University School of Medicine, Winston-Salem, North Carolina", "department": "None" }, { "first_name": "Amy", "middle_name": "", "last_name": "Hsu", "name_suffix": "", "institution": "The Cleveland Clinic, Department of Cardiovascular Medicine, Cleveland, Ohio", "department": "None" }, { "first_name": "Preeti", "middle_name": "", "last_name": "Jois", "name_suffix": "", "institution": "University of South Florida, Department of Emergency Medicine, Tampa, Florida", "department": "None" }, { "first_name": "Brian", "middle_name": "", "last_name": "Kaminski", "name_suffix": "", "institution": "Toledo Hospital, Department of Emergency Medicine, Toledo, Ohio", "department": "None" }, { "first_name": "Philip", "middle_name": "", "last_name": "Levy", "name_suffix": "", "institution": "Wayne State University School of Medicine and The Cardiovascular Research Institute, Department of Emergency Medicine, Detroit, Michigan", "department": "None" }, { "first_name": "Richard", "middle_name": "M.", "last_name": "Nowak", "name_suffix": "", "institution": "Henry Ford Hospital, Department of Emergency Medicine, Detroit, Michigan", "department": "None" }, { "first_name": "Jon", "middle_name": "W.", "last_name": "Schrock", "name_suffix": "", "institution": "Case Western Reserve University School of Medicine, Metro Health Medical Center, Department of Emergency Medicine, Cleveland, Ohio", "department": "None" } ], "date_submitted": "2014-07-28T19:13:41Z", "date_accepted": "2014-07-28T19:13:41Z", "date_published": "2015-03-11T20:34:11Z", "render_galley": null, "galleys": [ { "label": "", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/8467/galley/4890/download/" } ] }