Effectiveness of Captopril for the Management of Autonomic Dysreflexia in Spinal Cord Injuries

ABSTRACT

OBJECTIVE: In this study, we evaluate the efficacy of captopril comparing with nifedipine for management of hypertensive urgencies in autonomic dysreflexia in patients with spinal cord injury (SCI). METHOD: Twenty-four patients with SCI above T6 were documented and treated with drug therapy in this study whose systolic blood pressure (SBP) was at or above 150 mmHg despite the use of nondrug management during an autonomic dysreflexia episode. They were divided into two groups; captopril group (n=12) and nifedipine group (n= 12). Captopril group was administered captopril 25 mg sublingually and nifedipine group was administered nifedipine 10 mg sublingually. Diastolic blood pressure(DBP), systolic blood pressure (SBP), heart rate and side effects were monitored after administration. RESULTS: Mean DBP and SBP at baseline and 15, 30, 60 minutes after captopril were significantly decreased (p<0.05). There were no significant side effects such as reactive hypotension. The administration of nifedipine also successfully reduced mean SBP and DBP after 15, 30, 60 minutes (p<0.05), but some side effects were reported such as reactive hypotension, tarchycardia and headache. CONCLUSION: For the management of hypertension in autonomic dysreflexia, captopril appears to be one of the safe and effective methods in patients with SCI.