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 .
Comparison of nitroglycerin with nifedipine in patients with hypertensive crisis or severe hypertension
Summary To determine whether nitroglycerin is as effective as nifedipine in lowering the blood pressure in severe hypertension and hypertensive crisis , two goups of 20 patients received in r and om sequence either 1.2 mg nitroglycerin sublingually or a 10-mg nifedipine capsule , which was chewed and swallowed . The blood pressure fell after 5 min in the nitroglycerin group from 211/122 mmHg to 171/95 mmHG and after nifedipine from 210/118 to 185/102 mmHg . The greater effect of nitroglycerine may result from faster absorption through the oral mucosa than through the small intestinal mucosa where nifedipine is primarily absorbed . After 15–20 min a satisfactory reduction in blood pressure was reached in both groups : 157/91 and 158/92 mmHg , respectively . After 30 min the heart rate in the nitroglycerin group had decreased from 83 to 80/min , but in the nifedipine group it had increased from 84 to 90/min . The reduction in blood pressure persisted up to 6 h. No significant differences in side effects were determined . Since a hypertensive crisis is usually accompanied by left ventricular failure , pulmonary edema , angina pectoris , or infa rct ion , nitroglycerin has been definitively shown positively to influence these conditions , and preference should be given to nitroglycerin in the treatment of hypertensive crises
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 .