Abstract

The currently accepted drug of choice for treatment of hypertensive crisis is sublingual nifedipine. We compared the effects of sublingual captopril (25 mg) to those of nifedipine (10 mg) in 54 patients with this complication who came to the emergency room. Five min after administration of captopril, blood pressure decreased from 197.5 +/- 32.7/118.3 +/- 8.2 to 156 +/- 27.2/95.8 +/- 12.9 mmHg and heart rate decreased from 87.9 +/- 15.1 to 74.7 +/- 10.9 (p < 0.05). Blood pressure in the nifedipine group decreased from 198 +/- 27.3/120 +/- 9.8 to 147.7 +/- 17.8/86 +/- 17.9 (p < 0.05), while no change was observed in heart rate. Delayed measurements showed lower diastolic pressures at 60 and 75 min and lower systolic pressure at 120 min in the nifedipine group (p < 0.054). Few and not significantly different side effects were observed with both drugs. Thus, sublingual captopril is useful for treatment of hypertensive crisis.