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March 12, 1997

Nifedipine for Hypertensive Emergencies

Author Affiliations

Family Physicians Association of Flower Hospital Sylvania, Ohio

JAMA. 1997;277(10):788. doi:10.1001/jama.1997.03540340022016

To the Editor.  —The article by Dr Grossman and colleagues1 regarding the 1985 review by the Cardiorenal Advisory Committee of the Food and Drug Administration (FDA) of sublingual nifedipine is food for thought, but does little to convince the reader that this medication does not have a place in modern-day pharmacotherapy. If one considers the presented review of antihypertensive efficacy of nifedipine and examines the references pertaining to efficacy, it is evident that 21 of these references were published after 1985. This raises the question, if the FDA had this information in 1985, would it have come to a different conclusion concerning shortacting nifedipine use in hypertensive emergencies?Beyond encouraging discontinuation of the sublingual dosing method for nifedipine, the value of the article by Grossman et al appears to be its review of patient risk factors for developing a hypotensive episode with nifedipine. It would be prudent to avoid using short-acting nifedipine