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 .
Slow release nifedipine and atenolol as initial treatment in blacks with malignant hypertension.
We have compared the efficacy and safety of slow release nifedipine and atenolol given orally as initial treatment for malignant hypertension . Twenty consecutive black patients with untreated malignant hypertension , whose diastolic pressure remained greater than 120 mm Hg after 3 h bed rest , were r and omized to receive either slow release nifedipine 40 mg at 1 and 12 h , or atenolol 100 mg at 0 h only . Patients remained supine throughout the study . Blood pressure was measured using a semi-automatic recorder ( Omega 1000 ) at 15 min intervals from -3 to 24 h. Baseline blood pressure was similar in the nifedipine ( 233/142 mm Hg ) and atenolol ( 226/141 mm Hg ) groups . The rate of fall of pressure was greater after nifedipine whose maximum hypotensive effect occurred 4 - 5 h after each dose . Blood pressure decreased more slowly and more enduringly after atenolol , although the extent of fall was the same ( delta BP 5 h after first dose nifedipine = 67/41 mm Hg ; delta BP 16 h after atenolol = 64/40 mm Hg ) . There were no precipitous falls in pressure . No patient developed focal neurological signs , nor was heart failure precipitated by either form of treatment . These results support recommendations that most patients with malignant hypertension can be managed without recourse to parenteral therapy
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 .