Course of blood pressure within the first 12 h of hypertensive urgencies.
OBJECTIVE
To evaluate the course of blood pressure within 12 h of a hypertensive urgency with or without oral antihypertensive treatment prior to discharge of patients from hospital.


METHODS
A prospective, double-blinded, placebo-controlled and randomized clinical trial.


METHODS
Department of Emergency Medicine in a 2000-bed inner city hospital.


METHODS
Forty patients successfully treated for a hypertensive urgency with intravenous administration of urapidil.


METHODS
We administered 60 mg urapidil orally or placebo prior to discharge of patients from hospital and evaluated the course of blood pressure within 12 h of the urgency by use of an ambulatory blood pressure measurement unit.


METHODS
Mean systolic and diastolic blood pressures within the first 12 h of a hypertensive urgency and the number of hypertensive and hypotensive episodes.


RESULTS
Mean systolic and diastolic blood pressures were significantly lower in members of the urapidil group than they were in members of the placebo group (132 +/- 14 versus 147 +/- 18 mmHg, P = 0.003; 79 +/- 12 versus 87 +/- 14 mmHg, P = 0.047, respectively). The number of hypotensive episodes was similar for these two groups (three versus one, P = 0.32), whereas the number of hypertensive episodes was significantly lower for the urapidil group (13 versus 34, P = 0.001).


CONCLUSIONS
Oral medication with urapidil prior to discharge results in lower overall blood pressure levels and reduces the risk of hypertensive episodes recurring within 12 h of a hypertensive urgency. Therefore, we recommend this therapeutic approach for patients with hypertensive urgencies, who are treated with an intravenous antihypertensive drug.
Hirschl
M M
MM
Department of Emergency Medicine, University of Vienna, Austria. michael.hirschl@akh-wien.ac.at
Herkner
H
H
Bur
A
A
Woisetschläger
C
C
Gamper
G
G
Frossard
M
M
Laggner
A N
AN
D000284:Administration, Oral; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D004311:Double-Blind Method; D004630:Emergencies; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D013997:Time Factors
D000959:Antihypertensive Agents; D010879:Piperazines; C015568:urapidil