title: Nifedipine, Captopril or Sublingual Nitroglycerin, Which can Reduce Blood Pressure the Most?
abstract: BACKGROUND
  Hypertension (HTN) is one of the most important problems in all parts of the world. Although the disease is usually asymptomatic, its diagnosis and treatment are easy. The aim of this study was to compare the effect of Nifedipine (Adalat(®)), Captopril and sublingual Nitroglycerin on reducing blood pressure (BP).
  
  
  METHODS
  This study was a parallel group randomized controlled trial. From the patients referred to our heart clinic, 120 patients with severe HTN were enrolled in the study. The patients were randomly allocated into 3 groups A, B, and C. The patients were advised to use 5 drops of Adalat in group A, Captopril 25 mg sublingually in group B, and 1 sublingual Nitroglycerin pearl in group C. The BP was measured every 20 minutes during one hour.
  
  
  RESULTS
  Systolic BP was reduced significantly by Adalat and Captopril compared with sublingual Nitroglycerin in the 20(th), 40(th) and 60(th) minutes (P = 0.001), but there was no significant difference between Adalat and captopril in reducing systolic BP. In addition, the result of reducing diastolic BP was not significantly different among the three groups.
  
  
  CONCLUSIONS
  We saw the same effect on reducing BP by Captopril, Adalat, and sublingual Nitroglycerin. Among these three drugs, the side effects of Captopril were the least frequent. Adalat caused headache and flushing. Thus, it seems Captopril can be used instead of Adalat in medical centers.
authors.affiliation: Assistant Professor, Department of Cardiology, Imam Khomeini Hospital of Lorestan University of Medical Sciences, Lorestan, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Maleki
authors.forename: Masumeh
authors.initials: M
authors.lastname: Sadeghi
authors.forename: Mahyar
authors.initials: M
authors.lastname: Zaman
authors.forename: Mohammad Javad
authors.initials: MJ
authors.lastname: Tarrahi
authors.forename: Behjat
authors.initials: B
authors.lastname: Nabatchi