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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
06:59

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

[Systemic hypertension at emergency units. The use of symptomatic drugs as choice for management]

Sandro Gonçalves de Lima1, Luciana Simões do Nascimento, Cândido Nobre dos Santos Filho

  • 1Hospital Universitário Oswaldo Cruz, Recife, PE. sandrolima@cardiol.br

Arquivos Brasileiros De Cardiologia
|August 23, 2005
PubMed

Insights

Symptomatic patients with high blood pressure (hypertension) responded similarly to symptomatic or anti-hypertensive drugs. Both treatments effectively reduced blood pressure and symptoms, allowing for similar discharge rates in the emergency unit setting.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Pharmacology

Background:

  • Hypertensive emergencies require prompt and effective treatment.
  • Symptomatic medications and anti-hypertensive drugs are potential options for managing hypertensive crises.
  • Patient compliance with treatment and lifestyle modifications significantly impacts blood pressure control.

Purpose of the Study:

  • To compare the therapeutic efficacy of symptomatic medications versus anti-hypertensive drugs in hypertensive patients presenting with symptoms to the Emergency Unit.
  • To evaluate the impact of these treatments on patient symptom resolution and blood pressure reduction.

Main Methods:

  • A randomized, blind clinical trial was conducted with 100 hypertensive patients experiencing elevated systolic blood pressure (SBP) between 180-200 mmHg and/or diastolic blood pressure (DBP) between 110-120 mmHg.
  • Patients were randomized to receive either symptomatic medication (dipyrone or diazepam) or an anti-hypertensive drug (captopril).
  • Discharge criteria included resolution of symptoms and reduction of SBP to below 180 mmHg and DBP to below 110 mmHg within 90 minutes.

Main Results:

  • The study population (mean age 54.4 years) consisted primarily of females with chronic hypertension, irregular medication use, and obesity.
  • Headache, chest pain, and dyspnea were the most common presenting symptoms.
  • No statistically significant difference was observed in the number of patients meeting discharge criteria between the symptomatic drug group and the anti-hypertensive drug group (p=0.165).

Conclusions:

  • Symptomatic medications, while not statistically significant, led to a slightly higher rate of blood pressure reduction below discharge criteria compared to anti-hypertensive drugs.
  • Both treatment approaches were effective in resolving symptoms and reducing blood pressure in hypertensive patients in the emergency setting.
  • Patient characteristics such as prior hypertension diagnosis or treatment adherence did not influence discharge outcomes.
Abstract

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