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 .
Isradipine in the treatment of hypertensive crisis in ambulatory patients.
In order to investigate the efficacy of isradipine in the treatment of hypertensive crisis , we treated three groups of patients who had diastolic blood pressure ( DBP ) greater than 120 mm Hg , and who were without signs of acute target-organ damage .  Isradipine was given sublingually in doses of 1.25 mg ( group 1 ; n = 10 ) , 2.5 mg ( group 2 ; n = 10 ) , and 5 mg ( group 3 ; n = 7 ) . Mean arterial pressure ( MAP ) was reduced in all patients [ from 153.4 + /- 4.3 to 124.0 + /- 2.3 mm Hg at 60 min , and to 118.0 + /- 2.1 mm Hg at 2 h after administration ( p less than 0.001 ) ] . The heart rate ( HR ) did not change significantly ( from 82.4 + /- 3.7 to 84.0 + /- 6 beats/min ; NS ) . No significant differences were noted in the overall responses of the three groups ; however , blood pressure reduction was more rapid in the group receiving 5 mg compared with the other two dosages . These results show that isradipine given sublingually is effective in reducing the elevated blood pressure of a hypertensive crisis and is not accompanied by limiting side effects . Isradipine 's onset of action is early ( approximately 30 min after dosing ) and reaches its maximum blood pressure response within 2 h of administration . No dose-dependent reductions in blood pressure were observed with the dosage range employed in this study
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 .