Comparing oral captopril and sublingual nitrates in controlling urgent hypertension crisis
S.H. Sezavar, MD 1 F. Noori, MD 2 F. Noori, MD 3 Sh. Bohloli, PhD 4 H. Farshidi, MD 5 M. Shamshirgaran, MD 3
Departments of 1 Cardiovascular 4 Pharmacology, Ardabil University of Medical Sciences 2 Department of Pediatrics, Azad Islami University of Ardabil 3 General Physician 5 Department of Internal Medicine, Hormozgan University of Medical Sciences
ABSTRACT
Introduction: Hypertension crisis is one of the most common reasons of the patient’s reference to emergency units. Many intravenous and oral drugs are available for controlling hypertension crisis. Intravenous nitrates are one of these drugs but there are few studies regarding the effect of oral nitrates on hypertension crisis. This study compares the effect of oral captopril and sublingual isosorbide dinitrate in controlling urgent hypertension crisis.
Methods: In this double blind clinical trial 100 patients with urgent hypertension crisis (BP>180/110) without end organ damage took part. Fifty patients received 10 mg of sublingual isosorbide dinitrate and fifty others received 50 mg of captopril. The blood pressure of the patients was measured every ten minutes up to 90 and 60 minutes in captopril and isosorbide group respectively. The data were analyzed using T test and ANOVA.
Results: The patients were between 24-75 years old. In captopril group blood pressure decreased from 194±9 mmHg/115±2 mmHg to 152±7/86±2 and in isosrbide group from 198±10 mmHg/112±4 mmHg to 155±8 mmHg/81±3 mmHg. There was a 20.9% decrease in blood pressure in captopril group and a 21.63% decrease in isosrbide group. T test and ANOVA showed no significant difference between the two groups in reducing blood pressure.
Conclusion: This study indicated that 10 mg sublingual dinitrate is at least as effective as 50 mg captopril in controlling urgent hypertension crisis.
Key words: Captopril – Hypertension – Hypertension, Malignant – Nitroglycerin