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 .
Evaluation of the efficacy and safety of oral nicardipine in treatment of urgent hypertension: a multicenter, randomized, double-blind, parallel, placebo-controlled clinical trial.
This study was a prospect i ve , r and omized , double-blind , placebo-controlled clinical trial design ed to evaluate the safety and efficacy of oral nicardipine for the treatment of urgent hypertension in the emergency department . Of 57 patients with urgent hypertension 53 patients were enrolled : 36 men and 17 women , 43 black and 10 white , age range 48 + /- 11 years , and diastolic blood pressure 128 + /- 7 mm Hg . Patients were r and omly assigned to receive 30 mg nicardipine or placebo in blind fashion followed by 30 mg open-label nicardipine in nonresponders . Responders to one or two doses of nicardipine received 30 or 40 mg nicardipine three times a day for 1 week after discharge from the emergency department . Adequate blood pressure reduction , defined as a reduction of diastolic blood pressure to less than 100 mm Hg or by at least 20 mm Hg , was achieved in 65 % and 22 % of patients who received 30 mg nicardipine or placebo ( p = 0.002 ) . Adequate blood pressure reduction after administration of open-label nicardipine occurred in 76 % of the nonresponders to placebo . Blood pressure reductions were maintained at 1 week after discharge . The drug was well tolerated , and no significant adverse events occurred . We conclude that oral nicardipine is a safe and effective drug for the initial treatment of urgent hypertension
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 .