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Randomized Controlled Trial
. 2008 Sep;10(9):662-7.
doi: 10.1111/j.1751-7176.2008.00001.x.

Hypertensive urgencies in the emergency department: evaluating blood pressure response to rest and to antihypertensive drugs with different profiles

Daniel Grassi  1 , Martin O'Flaherty, Marcelo Pellizzari, Mario Bendersky, Pablo Rodriguez, Domingo Turri, Pedro Forcada, Keith C Ferdinand, Carol Kotliar; Group of Investigators of the REHASE Program
Collaborators, Affiliations
Randomized Controlled Trial

Hypertensive urgencies in the emergency department: evaluating blood pressure response to rest and to antihypertensive drugs with different profiles

Daniel Grassi et al. J Clin Hypertens (Greenwich). 2008 Sep.

Abstract

To study the efficacy of a treatment strategy for the management of hypertensive urgencies, the authors evaluated 549 patients admitted to the emergency department. They were first assigned to a 30-minute rest period, then a follow-up blood pressure measurement was carried out. Patients who did not respond to rest were randomly assigned to receive an oral dose of an antihypertensive drug with different mechanisms of action and pharmacodynamic properties (perindopril, amlodipine, or labetalol), and blood pressure was reassessed at 60- and 120-minute intervals. A satisfactory blood pressure response to rest (defined as postintervention systolic blood pressure < 180 mm Hg and diastolic blood pressure < 110 mm Hg, with at least a 20 mm Hg reduction in basal systolic blood pressure and/or a 10-mm Hg reduction in basal diastolic blood pressure) was observed in 31.9% of population. Among nonresponders, 79.1% had a satisfactory blood pressure response to the antihypertensive drug treatment in a 2-hour average follow-up period. No major adverse events were observed. This treatment strategy, based on standardized rest as an initial step and different antihypertensive drugs, can be effective and safe for the management of patients with hypertensive urgencies.

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Figures

Figure 1
Figure 1
Study design. SHT indicates severe hypertension; ATOD, acute target organ damage.
Figure 2
Figure 2
Blood pressure response to rest. SBP indicates systolic blood pressure; DBP, diastolic blood pressure.
Figure 3
Figure 3
Blood pressure response to drugs. SBP indicates systolic blood pressure; DBP, diastolic blood pressure.
See this image and copyright information in PMC

Comment in

  • Bed rest first for hypertensive urgencies?
    Moser M. Moser M. J Clin Hypertens (Greenwich). 2008 Sep;10(9):661. doi: 10.1111/j.1751-7176.2008.00008.x. J Clin Hypertens (Greenwich). 2008. PMID: 18844759 Free PMC article. No abstract available.

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