Comparing outcomes of clonidine and captopril in patients with hypertensive urgency: A randomized clinical trial

Area of Science:

• Cardiology
• Pharmacology
• Clinical Medicine

Background:

• Hypertension is a major global health risk, contributing significantly to mortality and healthcare costs, particularly in Eastern Europe and Central Asia.
• Hypertensive crisis, defined by blood pressure (BP) > 180/120 mmHg, necessitates prompt management and is categorized into hypertensive emergency and urgency.
• Understanding effective treatments for hypertensive urgency is crucial for preventing severe complications and reducing healthcare burdens.

Purpose of the Study:

• To compare the efficacy and safety of clonidine versus captopril in managing patients experiencing hypertensive urgency.
• To evaluate the duration of BP reduction and the incidence of adverse effects associated with each medication.

Main Methods:

• A parallel-group randomized clinical trial was conducted involving patients presenting with hypertensive crisis symptoms.
• Participants with systolic BP ≥ 180 mmHg or diastolic BP ≥ 110 mmHg, without end-organ damage, were randomized to receive either clonidine or captopril.
• Ideal therapeutic response was defined as a 25% decrease in blood pressure.

Main Results:

• Patients treated with clonidine achieved significant BP reduction faster than those receiving captopril (P = 0.016).
• The incidence of side effects, including headache, dizziness, dry mouth, and drowsiness, was significantly lower in the clonidine group compared to the captopril group (P < 0.05).

Conclusions:

• Clonidine demonstrated a superior therapeutic profile for hypertensive urgency, providing quicker relief and a better side effect profile than captopril.
• The findings support the use of clonidine as a preferred agent for the management of hypertensive urgency.