Comparison of Sublingual Captopril and Nifedipine in Immediate Treatment of Hypertensive Emergencies

Angeli, Paolo

doi:10.1001/archinte.1991.00400040032008

Cited by 40 publications

(18 citation statements)

References 17 publications

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“…The literature provides evidence of the benefits of the use of conventional captopril tablets by the sublingual route in hypertensive crises [6][7][8][9]. The present study examines a novel approach, that of buffered, sublingual administration of this ACE inhibitor.…”

Section: Discussionmentioning

confidence: 99%

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A pharmacokinetic and pharmacodynamic evaluation of buffered sublingual captopril in patients with congestive heart failure

McElnay

Al-Furaih

Hughes

et al. 1996

Eur J Clin Pharmacol

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Section: Discussionmentioning

confidence: 99%

“…A number of authors have reported that sublingual captopril can be safely and effectively used in hypertensive crises [6][7][8][9]. Evidence of the therapeutic benefit of unbuffered sublingual captopril in CHF patients was provided by the results of Haude et al [10].…”

Section: Introductionmentioning

confidence: 99%

A pharmacokinetic and pharmacodynamic evaluation of buffered sublingual captopril in patients with congestive heart failure

McElnay

Al-Furaih

Hughes

et al. 1996

Eur J Clin Pharmacol

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“…As a sublingual tablet, however, captopril showed no serious side effects. It should be noted that nifedipine can lower the pressure of blood more immediate than captopril, which this can also make this medication to its fatal side effects (19,20). However, nifedipine and captopril can only display the blood pressure control, means that their e cacy strongly depends on their half-life.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of midazolam administration to control blood pressure in patients diagnosed with ‘Hypertensive crisis’: a Randomized Clinical Trial

Enayatrad

et al. 2020

Preprint

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Introduction: Hypertensive crisis defines as a sudden rise in blood pressure that can adversely affect the vital organs. As such, it is recommended to take midazolam to lower the blood pressure in patients of hypertensive crisis. This study aims to investigate the midazolam efficacy as an emergency care to control the blood pressure in patients diagnosed with hypertensive crisis. Methods The current paper represents a double-blinded clinical trial study that examines the patients of the hypertensive crisis who referred to Imam Hossein Hospital of Shahroud, 2018. Patients with systolic/diastolic blood pressure greater than 180/110 mm Hg and with healthy vital organs were selected randomly and divided into three groups of 43 participants. All patients’ blood pressure in both arms, and after a period of 10 minutes in the left arm, was checked and was checked again after administering the medication for 4 times of 15 minutes till 1 hour complete. IBM SPSS Amos 23 was implemented. One-way ANOVA, Chi-Square and Repeated measure tests were performed to carry out statistical analysis. The level of significance of 0.05 was considered. Results in the group of midazolam, it was observed a reduction of 20.6% (P = 0.024), 17.4% (P = 0.001), and 19.1% (P = 0.009) for the systolic blood pressure, diastolic blood pressure, and blood pressure average, respectively. In such case, it was also indicated to be a significant difference of the reduction before and after the treatment. The group of captopril showed a decrease of 19.9% (P = 0.001), 13.5% (P = 0.008), and 16.7% (P = 0.001) for the systolic blood pressure, diastolic blood pressure, and blood pressure average, respectively. It was also observed to be a significant difference in reducing the blood pressure before and after the treatment. The group of midazolam and captopril showed the greatest reduction of blood pressure before, in the middle, and after carrying out the treatment methods. As such, systolic blood pressure, diastolic blood pressure, and the blood pressure average changed to the reduction of 23.5% (P = 0.047), 17.4% (P = 0.021), and 20.5% (P = 0.031), respectively. No significant difference was observed among these three groups (P = 0.239).

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“…EDITOR, - In their editorial on treating hypertension after stroke,1 Janice E O'Connell and Christopher S Gray refer to the use of sublingual nifedipine, citing an editorial in the Lancet,2 which in turn refers to the work of Angeli et al3 Sublingual nifedipine is often prescribed in severe hypertension of various aetiologies. The fact that it works, however, has nothing to do with it being sublingual 4.…”

mentioning

confidence: 99%

“…The fact that it works, however, has nothing to do with it being sublingual 4. O'Connell and Gray allude to this by suggesting nasogastric administration as an alternative route, and, crucially, in Angeli's study the patients were instructed to swallow their saliva after placing a perforated nifedipine capsule under their tongue 3. Since therapeutic amounts of nifedipine are absorbed only after the drug is swallowed the capsules should be bitten to release the contents and then swallowed as a glass of water is drunk 4.…”

mentioning

confidence: 99%

Treating hypertension after stroke

Macfarlane

1994

BMJ

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Comparison of Sublingual Captopril and Nifedipine in Immediate Treatment of Hypertensive Emergencies

Cited by 40 publications

References 17 publications

A pharmacokinetic and pharmacodynamic evaluation of buffered sublingual captopril in patients with congestive heart failure

A pharmacokinetic and pharmacodynamic evaluation of buffered sublingual captopril in patients with congestive heart failure

Efficacy of midazolam administration to control blood pressure in patients diagnosed with ‘Hypertensive crisis’: a Randomized Clinical Trial

Treating hypertension after stroke

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