title: Comparison of alprazolam versus captopril in high blood pressure: a randomized controlled trial.
abstract: OBJECTIVE. Anxiety is an important cause of acute blood pressure (BP) elevation. However, the role of anxiolysis in this situation is still controversial. In this study, the relationship of anxiety with BP and the effect of anxiolytic treatment on BP were investigated. METHODS. Emergency department (ED) patients with an initial systolic BP (SBP) ≥ 160 mmHg or diastolic BP (DBP) ≥ 100 mmHg but no end organ damage were approached for inclusion in the study. In those consenting to participate, anxiety levels were measured using the State-Trait Anxiety Index (STAI) and Visual Analog Scale for Anxiety (VAS-A). Patients were randomly assigned to receive oral alprazolam 0.5 mg or captopril 25 mg. BP and anxiety levels were measured at baseline and at 1 and 2 h after administration of the study medication. RESULTS. Of 133 patients meeting inclusion criteria, 53 patients agreed to participate. Of these, 27 patients (50.9%) received captopril and 26 patients (49.1%) received alprazolam. The majority of the patients had a high-level trait (96.2%, n = 51) and state anxiety (81.1%, n = 43). The mean SBP and VAS-A values of both patient groups dropped significantly over the 2 h, with no significant difference between the two groups. A significant association between SBP and VAS-A scores was found (F((2,50)) = 6.27, p = 0.004).
  
  
  CONCLUSIONS
  A significant association exists between the level of BP and anxiety in hypertensive ED patients. Alprazolam is as effective as captopril in lowering BP in ED patients with an initial SBP > 160 mmHg.
authors.affiliation: Department of Emergency Medicine, Kocaeli University, Turkey. serkanyilmaz@kocaeli.edu.tr
authors.forename: Serkan
authors.initials: S
authors.lastname: Yilmaz
authors.forename: Murat
authors.initials: M
authors.lastname: Pekdemir
authors.forename: Umit
authors.initials: U
authors.lastname: Tural
authors.forename: Mecit
authors.initials: M
authors.lastname: Uygun
mesh_terms: D000525:Alprazolam / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000188:drug therapy* / Q000503:physiopathology*; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000469:parasitology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D002216:Captopril; D000525:Alprazolam