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 the acute hypotensive effects of two different doses of nifedipine.
To determine whether a dose of 5 mg of nifedipine would be useful in the treatment of hypertensive emergencies , we compared the acute hypotensive effects of two different doses of nifedipine , 5 mg and 10 mg , in patients with severe hypertension . In this prospect i ve , r and omized , double-blind study , 30 consecutive black patients with diastolic blood pressure that was equal to or greater than 115 mm Hg received either a 5 mg or 10 mg nifedipine capsule and a placebo capsule , which matched that of the alternative strength . Patients were asked to bite the capsules and swallow the contents . Blood pressure response over 4 hours and adverse effects were monitored . Mean systolic blood pressure was reduced from 191.7 mm Hg ( 95 % confidence interval 170.8 to 212.7 mm Hg ) to 157.9 mm Hg ( 137.0 to 178.9 mm Hg ) and 206.1 mm Hg ( 185.1 to 227.0 mm Hg ) to 153.7 mm Hg ( 132.8 to 174.7 mm Hg ) in patients who were given 5 mg and 10 mg doses of nifedipine , respectively . Mean diastolic blood pressure in the group of patients that received 5 mg doses of nifedipine decreased from 128.2 mm Hg ( 115.6 to 140.7 mm Hg ) to 105.2 mm Hg ( 92.7 to 117.7 mm Hg ) ; the corresponding values in the group that received 10 mg doses of nifedipine were 129.9 mm Hg ( 117.4 to 142.5 mm Hg ) and 97.5 mm Hg ( 85.0 to 110.1 mm Hg ) , respectively . The minimum mean systolic blood pressures occurred 20 and 25 minutes after administration of the 5 mg and 10 mg capsules , respectively ; the minimum diastolic blood pressures were reached after 20 and 30 minutes , respectively . ( ABSTRACT TRUNCATED AT 250 WORDS
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 .