Which medication classes are recommended for blood pressure control in aortic dissection?

In the management of aortic dissection, the primary goals are to lower blood pressure and reduce the stress on the aortic wall. Nitroprusside is a potent vasodilator that acts quickly to reduce systemic vascular resistance and help control blood pressure in acute situations. It is particularly useful in hypertensive emergencies associated with aortic dissection.

Beta-blockers, on the other hand, are essential because they decrease heart rate and myocardial contractility, further reducing the aortic wall stress. This combination of a rapid-acting vasodilator with a heart rate-reducing agent is crucial in managing the acute phase of an aortic dissection. This strategy aims to achieve a lower systolic blood pressure target, typically around 100-120 mmHg, and to maintain a heart rate of less than 60 beats per minute to minimize the likelihood of aortic rupture or progression of the dissection.

Other medication classes, such as diuretics, angiotensin receptor blockers (ARBs), or ACE inhibitors, may be used for hypertension management in general but are not the first line in the emergency setting of aortic dissection due to their slower onset or less effective impact on heart rate and immediate hemodynamic control. Thus, the