Objective:
Hypertensive crisis stands out as a form of acute elevation of blood pressure and can manifest as hypertensive emergencies with target-organ damage or as hypertensive urgencies without target organ damage and level of diastolic blood pressure > = 120mmHg. Rilmenidine is a new centrally acting antihypertensive agent with selective agonist activity at imidazoline I1 receptors with less adverse effects than other centrally acting sympatholytic drugs and peak plasma concentration in 1.5–2 hours after ingestion. The aim of this study was to evaluate the efficacy and safety of rilmenidine in patients with uncomplicated hypertensive crisis in an internal medical clinic.
Design and method:
We performed a clinic observational study in which 26 patients (16 men, 10 women), medium age 62 ± 9.7 years, with hypertensive urgencies, received a single dose of 1 mg rilmenidine orally. Uncomplicated hypertensive urgencies ware diagnosed when diastolic BP exceeded 120 mmHg and/or systolic BP exceeded 180 mmHg without symptoms or acute target-organ damage. Office blood pressure and heart rate (HR) were measured at baseline and after 10, 30, 60 and 120 minutes after medication.
Results:
Baseline systolic BP was 199.7 ± 14.4 mmHg, baseline diastolic BP 107.8 ± 13.4 mmHg, and HR 75 ± 13.6 beats/min. Under the treatment with rilmenidine BP decreased by 11.4/3.2mmHg at 10 minute; 19.7/5.2 at 30 minute; 26.4/9.8 mmHg at 60 minute and 32.4/12.8mmHg after 120 minute following drug administration. HR decreased by 6.5beats/min after 120 minute. Excessive or orthostatic hypotensive effects were not observed.
Conclusions:
Rilmenidine can be regarded as an effective and relatively safe first line therapeutic possibility in uncomplicated hypertensive crisis.
