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 .
Sublingual and intravenous ketanserin versus sublingual nifedipine in the treatment of severe hypertension: a randomized study.
Thirty-seven patients with severe hypertension were r and omly assigned to receive 20 mg of ketanserin sublingually , 10 mg of ketanserin intravenously , or 20 mg of nifedipine sublingually . Systolic and diastolic blood pressures fell significantly after the three treatments . The maximum effects were reached 25 minutes after sublingual ketanserin ( with decreases of 7.7 % in systolic and 7.1 % in diastolic blood pressure ) , six minutes after intravenous ketanserin ( decreases of 9.4 % and 9.6 % , respectively ) , and 25 minutes after sublingual nifedipine ( decreases of 16.9 % and 15.9 % , respectively ) . Blood pressure returned to pretreatment levels 20 minutes after intravenous ketanserin .  Heart rate increased significantly in the group receiving nifedipine . No changes in plasma aldosterone , sodium , or potassium levels or in erythrocyte sodium and potassium levels were found after ketanserin . It is concluded that even intravenous ketanserin is inferior to sublingual nifedipine in the control of blood pressure
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 .