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 effect of the sublingually administered nifedipine and captopril via transcranial doppler ultrasonography during hypertensive crisis.
OBJECTIVE This study was design ed to show the effects of sublingually administered nifedipine and captopril on middle cerebral arterial blood flow during hypertensive crisis in the emergency department . METHODS AND RESULTS Transcranial Doppler ultrasonography ( TCD ) was performed on the patients fulfilling the criteria ( 15 patients given captopril , 13 patients given nifedipine , mean ( + /-SD ) age 56 + /- 11 and 54 + /- 10 years , respectively ) . Then , patients were r and omized into sublingually administered captopril or nifedipine groups and after the drug administration , TCD was repeated . Initial systolic and diastolic blood pressures were 200 + /- 21/125 + /- 21 mmHg in the captopril group and 199 + /- 17/ 123 + /- 20 mmHg in the nifedipine group . There was no significant difference between antihypertensive effects of the drugs after initiation of treatment . Before the treatment with captopril , middle cerebral artery ( MCA ) flow velocities ( Vm ) and pulsatility index ( PI ) were 76.74 + /- 6.38 cm/s and 1.18 + /- 0.09 , respectively . The values after the treatment with captopril were 78.21 + /- 5.24cm/s ( p < 0.05 ) and 0.92 + /- 0.08 ( p < 0.001 ) , respectively . Before the treatment with nifedipine , Vm and PIs were 64.73 + /- 5.11 cm/s and 1.14 + /- 0.18 , respectively . After the treatment with nifedipine , Vm was 60.04 + /- 5.36 cm/s ( p < 0.01 ) and PI was 1.21 + /- 0.09 ( p < 0.01 ) . CONCLUSION After treatment with captopril , PIs were decreased to normal limits but in the group treated with nifedipine , PIs increased to more pathological values . These results showed that we should reconsider the use of nifedipine in the emergency departments as an antihypertensive agent in hypertensive attack treatment
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 .