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Emergency Room Treatment of Hypertensive Crises

Sabina Salkic1, Selmira Brkic2, Olivera Batic-Mujanovic3

  • 1Emergency Medical Service Department, Community Health Care Center Tuzla.

Medical Archives (Sarajevo, Bosnia and Herzegovina)
|December 2, 2015
PubMed

Insights

Urapidil demonstrates superior efficiency in treating hypertensive urgency compared to captopril. While urapidil showed significant blood pressure reduction, captopril was more effective in older hypertensive patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Hypertensive urgency requires prompt and effective treatment to prevent target organ damage.
  • Alpha-1 adrenergic receptor inhibitors and angiotensin-converting enzyme (ACE) inhibitors are commonly used in managing hypertensive emergencies.
  • Evaluating treatment efficacy based on patient demographics and hypertension history is crucial for optimizing care.

Purpose of the Study:

  • To assess the effectiveness of urapidil (an alpha-1 adrenergic receptor inhibitor) versus captopril (an ACE inhibitor) in treating hypertensive urgency.
  • To analyze treatment efficiency in relation to patient age, duration of hypertension, and severity.

Main Methods:

  • A study involving 120 patients (aged 40-80) with verified hypertensive urgency was conducted.
  • Patients were divided into two groups: a control group receiving sublingual captopril and an experimental group receiving intravenous urapidil.
  • Blood pressure was monitored after initial and subsequent doses of the assigned medications.

Main Results:

  • The study included patients aged 40-80, with the highest prevalence in the 60-69 age group. Average hypertension duration was 11-20 years.
  • Initial average blood pressure was 213/130 mmHg. After treatment, both groups showed decreased blood pressure, with urapidil group showing a statistically significant reduction in mean artery pressure (p<0.001).
  • No significant difference in urapidil's efficiency was noted with patient age, but captopril was more effective in older patients (p=0.02). Treatment efficiency did not significantly differ based on hypertension duration for either drug.

Conclusions:

  • Urapidil is a more efficient treatment for hypertensive urgency due to a statistically significant reduction in mean artery pressure.
  • While urapidil's efficacy is independent of age, captopril demonstrated greater effectiveness in older individuals.
  • Neither urapidil nor captopril showed a statistically significant difference in efficiency concerning the duration of hypertension.
Abstract

Keywords:
captoprilhypertensive crisisurapidil

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