There is no RCT evidence demonstrating that antihypertensive drugs reduce mortality or morbidity in patients with hypertensive emergencies .
Furthermore , there is insufficient RCT evidence to determine which drug or drug class is most effective in reducing mortality and morbidity .
There were some minor differences in the degree of blood pressure lowering when one class of antihypertensive drug is compared to another .
However , the clinical significance is unknown .
Hypertensive emergencies occur when high blood pressure is associated with the presence of acute end-organ damage , such as hypertensive encephalopathy .
There is controversy as to when and which antihypertensive drugs to use in these situations .
Nifedipine in hypertensive emergencies.
The effects and safety of using oral nifedipine 10 - 20 mg as acute antihypertensive treatment were studied in a single-blind placebo-controlled study of 25 consecutive patients with very high blood pressure requiring emergency reduction . In addition the effect of this treatment on cerebral blood flow was investigated using xenon-133 in 10 patients r and omly allocated to receive oral nifedipine or intravenous clonidine . Whereas placebo did not alter the blood pressure , oral nifedipine significantly reduced the systolic and diastolic blood pressures in all 25 patients ( from 221 + /- 22/126 + /- 14 mm Hg to 152 + /- 20/89 + /- 12 mm Hg after 30 minutes , p less than 0.001 ) . Heart rate increased from 74 + /- 11 to 84 + /- 11 beats/minute ( p less than 0.01 ) ; this effect was inversely related to age ( r = -0.65 , p less than 0.01 ) . The falls in systolic and diastolic blood pressures were closely related to the blood pressures before treatment ) r = 0.67 , p less than 0.001 for systolic , and r = -0.58 , p less than 0.01 for diastolic values ) . No serious unwanted effects were observed . Measurement of cerebral blood flow after nifedipine showed an increase in flow in four out of five patients . Clonidine , by contrast , reduced cerebral blood flow in all patients by up to 28 % . Nifedipine is a simple , effective , and safe alternative drug for managing hypertensive emergencies , especially when continuous monitoring of the patient can not be guaranteed
There is no RCT evidence demonstrating that antihypertensive drugs reduce mortality or morbidity in patients with hypertensive emergencies .
Furthermore , there is insufficient RCT evidence to determine which drug or drug class is most effective in reducing mortality and morbidity .
There were some minor differences in the degree of blood pressure lowering when one class of antihypertensive drug is compared to another .
However , the clinical significance is unknown .
Hypertensive emergencies occur when high blood pressure is associated with the presence of acute end-organ damage , such as hypertensive encephalopathy .
There is controversy as to when and which antihypertensive drugs to use in these situations .