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 .
[The treatment of hypertensive crisis with nifedipine as the basis].
In 48 patients ( p ) with hypertensive crisis ( HC ) the effect of nifedipine ( N ) sublingual 10 - 20 mg alone ( group I , n = 19 , mean control AH + /- SD 232 + /- 15.3/132.5 + /- 4.9 mmHg ) or associated with furosemide and clonidine ( group II , n = 29 , AT 249 + /- 21/131.8 + /- 13.6 mmHg ) . In both groups the AT fell significantly starting five minutes after the administration of N ( except diastolic AT in group II ) ; the values measured at 45 min . being 177 + /- 32/105.4 + /- 13 mmHg in group I and 164.6 + /- 44.4/100.1 + /- 16.3 mmHg in group II ( the mean proportional difference at 45 min . for systolic AT was 24.6 + /- 11.4 % in group I and 28.7 + /- 12.2 % in group II ; for diastolic AT 20.5 + /- 9.4 % in group I , and 27 + /- 12.2 % for group II ) . The good clinical results consisted of lowering of the AT values below critical levels and clinical improvement in 42 p ( 87.5 % ) . Tolerance to N was good , in a single case was hypotension associated with fainting , both being promptly treated by simple means . CONCLUSIONS . 1 . N administered sublingual , 10 - 20 mg , alone or associated with furosemide has in most patients a rapid hypotensive effect , lowering AT below critical limits within 45 min ; 2 . the drug is readily administered and without the risk of side effects and can be used in the field in the emergency treatment of hypertension
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 .