title: Antianxiety treatment in patients with excessive hypertension.
abstract: OBJECTIVE
  There are no guidelines on how to treat patients with excessive hypertension. Anxiety is a common cause of excessive hypertension and therefore antianxiety treatment may be beneficial in these patients. We therefore compared the efficacy and safety of antianxiety treatment with sublingual captopril administration in patients with excessive hypertension and no evidence of acute target organ damage.
  
  
  METHODS
  Thirty-six patients (28 women and 8 men), mean age 60 +/- 2 years (range 36 to 85 years) who were referred to the emergency room because of excessive hypertension (>190/100 mm Hg) without evidence of acute target organ damage were randomized to receive either oral diazepam, 5 mg (n = 17, study group) or sublingual captopril, 25 mg (n = 19, control group). Blood pressure (BP) and heart rate were recorded hourly for 3 h.
  
  
  RESULTS
  Both treatments decreased BP significantly (from 213 +/- 5/105 +/- 3 to 170 +/- 8/88 +/- 6 mm Hg in the study group, and from 208 +/- 5/107 +/- 3 to 181 +/- 8/95 +/- 3 mm Hg in the control group (P < .01 v initial BP). One patient in each group was hospitalized because of sustained excessive hypertension.
  
  
  CONCLUSIONS
  Antianxiety treatment is effective in lowering BP in patients with excessive hypertension. Thus, anxiolytic treatment may be considered in patients with excessive hypertension without acute target organ damage. Further large placebo controlled studies are required to prove the benefit of anxiolytic agents.
authors.affiliation: Internal Medicine D and the Hypertension Unit, The Chaim Sheba Medical Center, Tel Aviv University, Sackler School of Medicine, Tel-Hashomer 52621, Israel. gross-e@zahav.net.il
authors.forename: Ehud
authors.initials: E
authors.lastname: Grossman
authors.forename: Moshe
authors.initials: M
authors.lastname: Nadler
authors.forename: Yehonatan
authors.initials: Y
authors.lastname: Sharabi
authors.forename: Michael
authors.initials: M
authors.lastname: Thaler
authors.forename: Amir
authors.initials: A
authors.lastname: Shachar
authors.forename: Arie
authors.initials: A
authors.lastname: Shamiss
mesh_terms: D000284:Administration, Oral; D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000008:administration & dosage / Q000627:therapeutic use*; D003975:Diazepam / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents; D000959:Antihypertensive Agents; D002216:Captopril; D003975:Diazepam