RESUMO
Hypertensive crisis is defined as a severe elevation in blood pressure [BP] without target organ injury. There are few data about the efficacy and safety of comparative oral antihypertensive drugs. To compare the efficacy and safety of oral captopril [25 mg] and nicardipine [20 mg] in hypertensive crisis. This prospective, randomized study included 50 patients attended at the emergency department with a hypertensive crisis [arterial blood pressure of at least 180/110 mmHg without target organ damage confirmed after 15 min of rest. Systolic [SBP] and diastolic blood pressure [DBP] and heart rate [HR] were assessed at several intervals during 4 h after the drug administration. Therapeutic success was defined by a SBP = 160 and DBP = 90 mmHg two hours after drug administration. The initial clinical characteristics as age, sex, initial systolic and diastolic BP and HR were no different in the two groups. BP levels started to significantly decrease within 15 minutes. At 2 hours, SBP and DBP dropped were similar in captopril group and nicardipine group, respectively to 162/94 vs 161/89 mmHg; p=ns. The therapeutic success at the second hour has been obtained in 68% of cases in the two groups. Age >70 years was a predictor's factor of therapeutic failure in the captopril group. Heart rate significantly dropped after 30 min in the captopril group [82.3 +/- 11.8 vs 77.6 +/- 12.7 c/min; p=0.037]. This effect was maintained over four hours. There were no side effects in this study. Oral captopril or nicardipine are efficacy and safe in the treatment of hypertensive crisis
Assuntos
Humanos , Masculino , Feminino , Captopril/farmacologia , Nicardipino/farmacologia , Administração Oral , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Pressão Sanguínea , Sístole , Diástole , Frequência CardíacaRESUMO
The goal of this study was to compare the clinical presentation and angiographic morphology of patients having an unstable angina pectoris. A total of 321 patients were consecutively studied and underwent cardiac catheterization, mean age 59 + 6 years. According to Braunwald classification, class III was predominant [58%] On coronary angiography, 148 patients had single vessel disease, double-vessel in 92 and triple-vessel in 64. Morphology of coronary artery lesions was classified according to Ambrose's classification, 100 patients had simple lesions [type I or IIA], 204 patients had complex lesions [type IIB, Ill, intracoronary thrombus or total occlusion]. Thoracic rest pain [class III] or postinfarction angina [class C], were associated with the presence of complex lesions. This subgroup of high risk patients would benefit from either Glycoprotein IIb/IIIa blockers with an early revascularisation strategy