Clevidipine vs. nicardipine in hypertensive crisis: a systematic review and meta-analysis.
6 affiliations
- 1Indiana University School of Medicine, Muncie, Indiana, United States. [email protected].
- 2King Edward Medical University, Lahore, Punjab, Pakistan.
- 3Allama Iqbal MedicalCollege, Lahore, Punjab, Pakistan.
- 4Dow University of Health Sciences (DUHS), Karachi, Pakistan.
- 5Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan.
- 6Khyber Medical College Peshawar, Peshawar, Pakistan.
Abstract
Background
Clevidipine and nicardipine are commonly used intravenous calcium channel blockers for the management of hypertensive crises. However, comparative evidence regarding their efficacy and safety remains limited.Methods
We conducted a systematic review and meta-analysis of randomized controlled trials and observational studies comparing intravenous clevidipine and nicardipine in adults with hypertensive crises. The primary outcome was achievement of target blood pressure reduction. Secondary outcomes included medication volume and blood pressure over-reduction. Random-effects models were used, and certainty of evidence was assessed using the GRADE framework.Results
Three studies involving 599 patients were included. Clevidipine and nicardipine demonstrated comparable achievement of target blood pressure reduction (OR 0.96, 95% CI 0.48-1.94; I² = 60%; very low-certainty evidence). Clevidipine was associated with lower odds of blood pressure over-reduction (OR 0.44, 95% CI 0.21-0.93; I² = 0%) and lower medication volume (MD - 258.43 mL, 95% CI - 313.38 to - 203.48 mL; I² = 0%).Conclusion
Clevidipine and nicardipine demonstrated comparable efficacy in achieving target blood pressure reduction in hypertensive crises. Although clevidipine was associated with lower odds of blood pressure over-reduction and lower medication volume, the evidence base was limited and the certainty of evidence for the primary outcome was very low. These findings should be interpreted cautiously and considered hypothesis-generating until confirmed by larger, high-quality randomized controlled trials.
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BibTeX
@article{abid2026clevidipine,
title = {{Clevidipine vs. nicardipine in hypertensive crisis: a systematic review and meta-analysis.}},
author = {Hassaan Abid and Syed Mohamin Abbas Shah and Amina Zia Rashid and Bisma Tasawar and Rimsha Adnan and Sohana Memon and Gaaitri Lohano and Muhammad Jawad and Muhammad Vazaym and Muhammad Junaid},
journal = {BMC cardiovascular disorders},
year = {2026},
month = jul,
doi = {10.1186/s12872-026-06345-z},
url = {https://europepmc.org/article/MED/42897471},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clevidipine vs. nicardipine in hypertensive crisis: a systematic review and meta-analysis.
AU - Hassaan Abid
AU - Syed Mohamin Abbas Shah
AU - Amina Zia Rashid
AU - Bisma Tasawar
AU - Rimsha Adnan
AU - Sohana Memon
AU - Gaaitri Lohano
AU - Muhammad Jawad
AU - Muhammad Vazaym
AU - Muhammad Junaid
PY - 2026
DA - 2026/07/01
JO - BMC cardiovascular disorders
DO - 10.1186/s12872-026-06345-z
UR - https://europepmc.org/article/MED/42897471
AB - Background Clevidipine and nicardipine are commonly used intravenous calcium channel blockers for the management of hypertensive crises. However, comparative evidence regarding their efficacy and safety remains limited.Methods We conducted a systematic review and meta-analysis of randomized controlled trials and observational studies comparing intravenous clevidipine and nicardipine in adults with hypertensive crises. The primary outcome was achievement of target blood pressure reduction. Secondary outcomes included medication volume and blood pressure over-reduction. Random-effects models were used, and certainty of evidence was assessed using the GRADE framework.Results Three studies involving 599 patients were included. Clevidipine and nicardipine demonstrated comparable achievement of target blood pressure reduction (OR 0.96, 95% CI 0.48-1.94; I² = 60%; very low-certainty evidence). Clevidipine was associated with lower odds of blood pressure over-reduction (OR 0.44, 95% CI 0.21-0.93; I² = 0%) and lower medication volume (MD - 258.43 mL, 95% CI - 313.38 to - 203.48 mL; I² = 0%).Conclusion Clevidipine and nicardipine demonstrated comparable efficacy in achieving target blood pressure reduction in hypertensive crises. Although clevidipine was associated with lower odds of blood pressure over-reduction and lower medication volume, the evidence base was limited and the certainty of evidence for the primary outcome was very low. These findings should be interpreted cautiously and considered hypothesis-generating until confirmed by larger, high-quality randomized controlled trials.
SN - 1471-2261
ER -