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 .
Long-acting lacidipine versus short-acting nifedipine in the treatment of asymptomatic acute blood pressure increase.
We compared antihypertensive efficacy and safety of a single administration of equipotent doses of lacidipine versus nifedipine in the hypertensive urgencies . Twenty-nine asymptomatic essential hypertensive patients ( nine men , 20 women ) with a mean age of 55.03+/-11.19 years and baseline diastolic blood pressure ( DBP ) of > or = 120 mm Hg after resting 30 min , not taking antihypertensive drugs for the last 24 h , were r and omized in a single-blind fashion to receive lacidipine , 4 mg ( LCD , 15 patients ) or short-acting nifedipine , 20 mg ( NFD , 14 patients ) in a single dose . Blood pressure ( BP ) and heart rate ( HR ) were taken every 30 min during the first 8 h and every 2 h until 24 h of follow-up . Baseline BP values were similar in the two groups ( LCD , 222.5+/-32.8/124.6+/-8.4 mm Hg vs. NFD , 215.9+/-20.6/128+/-7.7 mm Hg ; p = NS ) . Both drugs promoted a significant reduction of systolic blood pressure ( SBP ; 169.6+/-27.8 vs. 170.6+/-25.3 mm Hg ) and diastolic blood pressure ( DBP ; 104.1+/-16 vs. 102.9+/-12.4 mm Hg ) after 8 h. However , either SBP ( 165+/-27.3 vs. 190.6+/-18.2 mm Hg ; p = 0.008 ) and DBP ( 99.9+/-12.3 vs. 117.2+/-11.4 mm Hg ; p = 0.001 ) were significantly higher in the NFD group after 24-h dosing . Eleven patients in the LCD group had a decrease in BP > 25 % of the baseline value both 8 and 24 h after the dose . Although 10 patients showed the same response in the NFD group 8 h after the dose , only four patients maintained these values at 24 h. One patient treated with NFD had a transient cerebrovascular ischemic attack . No adverse effects were observed in the LCD group . We conclude that the long-acting calcium antagonist lacidipine was more effective than the short-acting nifedipine in both controlling BP and maintaining this BP reduction over 8 h in essential hypertensive patients with acute asymptomatic BP increase
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 .