Document Detail


Hypertensive urgencies in the emergency department: evaluating blood pressure response to rest and to antihypertensive drugs with different profiles.
MedLine Citation:
PMID:  18844760     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Daniel Grassi; Martin O'Flaherty; Marcelo Pellizzari; Mario Bendersky; Pablo Rodriguez; Domingo Turri; Pedro Forcada; Keith C Ferdinand; Carol Kotliar;
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  10     ISSN:  1524-6175     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-10-10     Completed Date:  2009-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  662-7     Citation Subset:  IM    
Affiliation:
Internal Medicine Department, Austral University Hospital, Buenos Aires, Argentina. dgrassi@cas.austral.edu.ar
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MeSH Terms
Descriptor/Qualifier:
Amlodipine / therapeutic use
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects*
Combined Modality Therapy
Emergencies*
Emergency Service, Hospital / statistics & numerical data*
Female
Follow-Up Studies
Humans
Hypertension / physiopathology,  therapy*
Labetalol / therapeutic use
Male
Middle Aged
Perindopril / therapeutic use
Rest / physiology*
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 36894-69-6/Labetalol; 82834-16-0/Perindopril; 88150-42-9/Amlodipine
Investigator
Investigator/Affiliation:
C Kotliar / ; M Bendersky / ; M Díaz / ; D Ferrante / ; R Martín / ; M Pellizzari / ; P Rodríguez / ; D Turri / ; D Grassi / ; K Ferdinand / ; H Fernández / ; P Forcada / ; M P Cobos / ; S Riviera / ; A Sáenz Valiente / ; C Bellido / ; E Butori / ; C Borrego / ; M Boscaro / ; G Calderón / ; R Celsi / ; C Cuneo / ; J Chibaut / ; J O'Donell / ; M Duarte / ; I Elliff / ; E Farias / ; A Faurie / ; J J Fuselli / ; R Gambarte / ; R Ingaramo / ; M Marín / ; R Martingano / ; R Merbilhaá / ; A Mulassi / ; L Olmos / ; H Peralta / ; J C Pereyra / ; D Piskorsz / ; R Porcile / ; J L Rescio / ; L Romera / ; P Rumi / ; A Sáenz / ; V Tarasiuk / ; F Villafaññe / ; N Vita / ; E Ylarri /
Comments/Corrections
Comment In:
J Clin Hypertens (Greenwich). 2008 Sep;10(9):661   [PMID:  18844759 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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