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 .
Intravenous urapidil versus sublingual nifedipine in the treatment of hypertensive urgencies.
In a 6-month prospect i ve study , the efficacy and safety of urapidil and nifedipine in an outpatient population with hypertensive urgencies ( systolic blood pressure > 200 mm Hg ; diastolic blood pressure > 110 mm Hg ) was investigated . Response to treatment was defined as a stable reduction of systolic blood pressure below 180 mm Hg and diastolic blood pressure below 100 mm Hg 15 minutes after application of a single dose of either 25 mg urapidil intravenously ( N = 26 ) or 10 mg nifedipine sublingually ( N = 27 ) . If the blood pressure was still elevated , a second dose of 10 mg nifedipine or 12.5 mg urapidil was given , and blood pressure response was evaluated 15 minutes after application of the second dose according to the aforementioned criteria s. After the first application of nifedipine , 19 ( 70 % ) responders have been observed . Eight patients needed an additional 10 mg of nifedipine . In four of these patients , no reduction of blood pressure was observed after a second dose of nifedipine . In contrast , 24 ( 92 % ) patients responded well to the first application of 25 mg of urapidil . Two patients required a second dose of 12.5 mg of urapidil , but no nonresponder to urapidil was observed . No severe side-effects were noted in both groups . Intravenous urapidil is a highly effective drug in the treatment of hypertensive urgencies and is more effective than sublingual nifedipine , because the number of patients treated successfully was significantly higher
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 .