Treatment of hypertensive emergencies with nifedipine

The effects and safety of using sublingually nifedipine 10-20 mg as acute antihypertensive treatment were evaluated in 108 patients with hypertensive emergencies or urgency without intensive care monitoring. Before treatment, mean systolic blood pressure was 220 +/- 28 mmHg, mean diastolic blood pressure was 125 +/- 15 mmHg and mean arterial pressure was 155 +/- 14 mmHg. Administration of 10 mg of sublingual nifedipine reduced the blood pressure within 10 min and produced a peak effect level between 30 to 40 min. Blood pressure decreased significantly to a mean 155 +/- 20 and 92 +/- 14 mmHg systolic and diastolic blood pressure, respectively. Minimal adverse effects was observed. Five patients, required additional therapy with other antihypertensive drugs. Heart rate increased from 74 +/- 10 to 84 +/- 10 beats per min. The response to nifedipine correlated with the blood pressure value prior to treatment, but did not correlate with age or the type of hypertensive emergency. These results indicate that nifedipine administered sublingually is a simple, effective, and safe agent for treating hypertensive emergencies, especially for the patients in whom intensive care monitoring cannot be guaranteed.