Comparing oral captopril and sublingual nitrates in controlling urgent hypertension crisis


Seyed Hashem Sezavar 1 , * , Ferydoun Noori 2 , Farhad Noori 3 , Shahab Bohloli 4 , Hossein Farshidi 5 , Seyed Morteza Shamshirgaran 3

1 Departments of Cardiovascular, Ardabil University of Medical Sciences, Ardabil, Iran.

2 Department of Pediatrics, Azad Islami University of Ardabil, Ardabil, Iran.

3 General Physician.

4 Pharmacology, Ardabil University of Medical Sciences, Ardabil, Iran.

5 Department of Internal Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

How to Cite: Sezavar S H, Noori F, Noori F, Bohloli S, Farshidi H, et al. Comparing oral captopril and sublingual nitrates in controlling urgent hypertension crisis, Hormozgan Med J. 2004 ; 8(3):e90623.


Hormozgan Medical Journal: 8 (3); e90623
Published Online: August 10, 2004
Article Type: Research Article
Received: April 08, 2004
Accepted: August 10, 2004


Introduction: Hypertension crisis is one of the most common reasons of the
patient’s reference to emergency units. Many intravenous and oral drugs are
available for controlling hypertension crisis. Intravenous nitrates are one of these
drugs but there are few studies regarding the effect of oral nitrates on
hypertension crisis. This study compares the effect of oral captopril and
sublingual isosorbide dinitrate in controlling urgent hypertension crisis.
Methods: In this double blind clinical trial 100 patients with urgent hypertension
crisis (BP>180/110) without end organ damage took part. Fifty patients received
10 mg of sublingual isosorbide dinitrate and fifty others received 50 mg of
captopril. The blood pressure of the patients was measured every ten minutes up
to 90 and 60 minutes in captopril and isosorbide group respectively. The data
were analyzed using T test and ANOVA.
Results: The patients were between 24-75 years old. In captopril group blood
pressure decreased from 194±9 mmHg/115±2 mmHg to 152±7/86±2 and in
isosrbide group from 198±10 mmHg/112±4 mmHg to 155±8 mmHg/81±3
mmHg. There was a 20.9% decrease in blood pressure in captopril group and a
21.63% decrease in isosrbide group. T test and ANOVA showed no significant
difference between the two groups in reducing blood pressure.
Conclusion: This study indicated that 10 mg sublingual dinitrate is at least as
effective as 50 mg captopril in controlling urgent hypertension crisis.



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