We started him on oral anti-hypertensive drugs and began lowering the nitroprusside dose. Most of the 20 million hypertensives in the country never require hospitalization for high blood pressure, let alone intensive care. If a patient is compliant in taking medication and receives good followup in the clinic or office, blood pressure can usually be controlled. Paradoxically, an explosion in the number of medications in recent years has made treatment both easier and more complicated. Doctors commonly prescribe captopril and other ACE inhibitors in place of an older drug type, such as a diuretic, whose side effects may be better appreciated.
ACE inhibitors have two peculiar side effects.
Sometimes patients go through many tests before the side effect is appreciated. If the swelling is severe the patient will be hospitalized for observation. A single drug is usually prescribed for mild to moderate elevations of blood pressure. Two or more drugs are used for severe cases or when hypertension doesn't respond to a single agent. The actual dose of any drug depends on the patient's tolerance and response.