[Comparison of the effects of diazepam, nifedipine, propranolol and a combination of nifedipine and propranolol, by sublingual administration, in patients with hypertensive crisis].
OBJECTIVE
To evaluate the effects of sublingual administration of diazepam, nifedipine, propranolol and the association of nifedipine with propranolol patients with hypertensive crisis.


METHODS
Eighty patients with hypertensive crisis, DAP greater than 120 mmHg, and mean age of 54 +/- 7.4 years, 33 women and 47 men, were evaluated. The AP was measured with an aneroid sphygmomanometer, in mmHg, in orthostatic position, before and after 10, 20, 30 and 60 minutes of treatment. The heart rate in one minute was also measured at the same intervals. The patients were divided randomly into four groups and treated, respectively, with 10 mg of diazepam, 10 mg of nifedipine, 40 mg of propranolol and 10 mg of nifedipine associated with 40 mg of propranolol.


RESULTS
A significant and gradual reduction of SAP and DAP were observed in all groups of patients. The percentage of reduction, after 60 minutes, for SAP was, respectively, 10.1%, 12.9%, 15.4% and 16%, and for DAP 7.7%, 11.3%, 13.6% and 13% in groups I to IV. The heart rate did not change in groups I and II, but significative reduction was observed in groups III (p = 0.002) and IV (p = 0.009).


CONCLUSIONS
The drugs used were effective for the treatment of hypertensive crisis, and the sublingual administration is an important and easy way for their administration.
Mansur
A de P
Ade P
Instituto do Coração, Hospital das Clínicas, São Paulo.
Ramires
J A
JA
Avakian
S D
SD
de Paula
R S
RS
Pileggi
F
F
D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D003975:Diazepam / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D011433:Propranolol / Q000627:therapeutic use*; D012307:Risk Factors
D011433:Propranolol; D009543:Nifedipine; D003975:Diazepam
Efeito comparativo do diazepam, nifedipina, propranolol e da associação nifedipina e propranolol, por via sublingual, em pacientes com crise hipertensiva.