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 .
[The use of sublingual captopril in hypertensive crises].
The purpose of this study was to evaluate the antihypertensive efficacy of captopril ( C ) and its correlation with body mass index ( BMI ) , age and initial blood pressure ( BP ) in hypertensive crises . The time of the beginning of the antihypertensive effect of C and its side effects were evaluated . Twenty patients , aged between 22 and 59 years , were included in this investigation . BP was measured after 15 min of rest ; age , weight and height were recorded and BMI was calculated using the st and ard formula ( Kg/m2 ) . Patients were not taking antihypertensive medications . After the placebo was given to the patients , BP was measured at 30 and 60 min . Sublingual captopril 25 mg was administered and BP was again measured at 5 , 10 , 15 , 30 , 60 , 120 y 240 min . There was not statistically significant difference between the values of BP before and after placebo . A significant decrease was observed post C , from 182.6/123.6 to 174.6/117.3 ( p : SN/p < 0.02 ) in 10 min . , to 169.9/114.9 ( p < 0.04/p < 0.001 ) in 15 min . , to 167.7/112.2 ( p < 0.02/p < 0.0001 ) in 30 min . , to 164.3/108.8 ( p < 0.002/p < 0.0001 ) in 60 min . , to 156.9/106.5 ( p < 0.0001/p < 0.0001 ) in 120 min . , to 161.3/107.0 ( p < 0.0002/p < 0.0001 ) in 240 min . In 15 patients there was a decrease in diastolic BP > or = 5 mmHg , 10 min . post C. No correlation was found between decrease in BP and age , nor with BMI . Pearson r correlation index between the decrease in systolic BP and initial systolic BP was 0.63 ( p < 0.003 ) and between the decrease in diastolic BP and initial diastolic BP , 0.59 ( p < 0.005 ) . Secondary effects were mild and well tolerated . In conclusion , C effectively reduced BP in hypertensive crises .  Because the efficacy of C , its rapid onset of action and minimal side effects , sublingual Captopril should be considered a first line drug for hypertensive crises
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 .