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 .
A comparison of safety and efficacy of sublingual captopril with sublingual nifedipine in hypertensive crisis
Sublingual nifedipine is commonly used in hypertensive crisis , however , it may result in several adverse effects such as reflex tachycardia , headache , and flushing . Research is continuing to find a new drug that has the same efficiency and fewer side effects . Sublingual captopril , a new preparation of angiotensin-converting enzyme inhibitor , lowers blood pressure . It is not known whether it is effective in these emergent clinical setting s. Therefore we design ed a r and omized , double-blind study to compare the efficacy and safety of those two drugs in hypertensive crisis . Eighty patients ( 32 male and 48 female ) with hypertensive crisis were included in the study ; their mean age was 43.4 ± 7.9 years . Nifedipine 10 mg was given sublingually to 34 and captopril 25 mg to 46 patients r and omly . There was no difference between the two drugs with respect to their antihypertensive effect . Heart rate significantly dropped ( p<0.01 and p<0.001 ) in the patients taking captopril , but no changes were observed in the patients taking nifedipine . Twenty-three of 34 patients taking nifedipine  encountered adverse effects . Adverse effects were observed in only three patients taking captopril ( p<0.001 ) . Sublingual captopril is as effective as and has less side effects  than sublingual nifedipine . Because sublingual captopril has fewer side effects , it may be safer than nifedipine in the treatment of hypertensive crisis
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 .