There is important evidence in favor of the use of angiotensin-converting enzyme inhibitors for treating hypertensive urgencies , compared with calcium channel blockers , considering the better effectiveness and the lower frequency of adverse effects ( like headache and flushing )
CONTEXT AND OBJECTIVE Hypertensive urgencies are defined as severe elevations in blood pressure without evidence of acute or progressive target-organ damage .
The need for treatment is considered urgent but allows for slow control using oral or sublingual drugs .
If the increase in blood pressure is not associated with risk to life or acute target-organ damage , blood pressure control must be implemented slowly over 24 hours .
For hypertensive urgencies , it is not known which class of antihypertensive drug provides the best results and there is controversy regarding when to use antihypertensive drugs and which ones to use in these situations .
The aim of this review was to assess the effectiveness and safety of oral drugs for hypertensive urgencies .
Prehospital use of nifedipine for severe hypertension.
The prehospital management of severe hypertension is limited by a paucity of pharmacologic agents suitable for field use . This prospect i ve study was design ed to test the safety and efficacy of intraoral nifedipine therapy in 50 patients with severe hypertension being transported by an urban emergency medical service system . Ten milligrams of nifedipine were administered . Serial blood pressure determinations were obtained at 3 , 5 , 10 , and 15 minutes and patients were observed for possible side effects . A marked effect on systolic blood pressure ( SP ) , diastolic blood pressure ( DP ) , and mean arterial pressure ( MAP ) was evident and was statistically significant in all three categories by 3 minutes . MAP decreased from 169 to 129 mm Hg ( delta MAP of 40 mm Hg ) at 15 minutes with parallel changes in the SP ( 55 mm Hg ) and delta DP ( 32 mm Hg ) . These changes were highly significant ( P less than .01 ) when compared with those of 50 historical controls . No evidence of severe adverse effects were noted . Nifedipine appears to be a promising agent for the prehospital treatment of severe hypertension , but its proper role is not yet defined
There is important evidence in favor of the use of angiotensin-converting enzyme inhibitors for treating hypertensive urgencies , compared with calcium channel blockers , considering the better effectiveness and the lower frequency of adverse effects ( like headache and flushing )
CONTEXT AND OBJECTIVE Hypertensive urgencies are defined as severe elevations in blood pressure without evidence of acute or progressive target-organ damage .
The need for treatment is considered urgent but allows for slow control using oral or sublingual drugs .
If the increase in blood pressure is not associated with risk to life or acute target-organ damage , blood pressure control must be implemented slowly over 24 hours .
For hypertensive urgencies , it is not known which class of antihypertensive drug provides the best results and there is controversy regarding when to use antihypertensive drugs and which ones to use in these situations .
The aim of this review was to assess the effectiveness and safety of oral drugs for hypertensive urgencies .