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Journal of Hypertension:
Original article

Course of blood pressure within the first 12 h of hypertensive urgencies

Hirschl, Michael M.1,2; Herkner, Harald1; Bur, Andreas1; Woisetschläger, Christian1; Gamper, Gunnar1; Frossard, Martin1; Laggner, Anton N.1

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Abstract

Objective: To evaluate the course of blood pressure within 12 h of a hypertensive urgency with or without oral antihypertensive treatment prior to discharge of patients from hospital.

Design: A prospective, double-blinded, placebo-controlled and randomized clinical trial.

Setting: Department of Emergency Medicine in a 2000-bed inner city hospital.

Patients: Forty patients successfully treated for a hypertensive urgency with intravenous administration of urapidil.

Interventions: We administered 60 mg urapidil orally or placebo prior to discharge of patients from hospital and evaluated the course of blood pressure within 12 h of the urgency by use of an ambulatory blood pressure measurement unit.

Main outcome measures: Mean systolic and diastolic blood pressures within the first 12 h of a hypertensive urgency and the number of hypertensive and hypotensive episodes.

Results: Mean systolic and diastolic blood pressures were significantly lower in members of the urapidil group than they were in members of the placebo group (132 ± 14 versus 147 ± 18 mmHg, P = 0.003; 79 ± 12 versus 87 ± 14 mmHg, P = 0.047, respectively). The number of hypotensive episodes was similar for these two groups (three versus one, P = 0.32), whereas the number of hypertensive episodes was significantly lower for the urapidil group (13 versus 34, P = 0.001).

Conclusions: Oral medication with urapidil prior to discharge results in lower overall blood pressure levels and reduces the risk of hypertensive episodes recurring within 12 h of a hypertensive urgency. Therefore, we recommend this therapeutic approach for patients with hypertensive urgencies, who are treated with an intravenous antihypertensive drug.

© 1998 Lippincott Williams & Wilkins, Inc.

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