title: Sublingual vs. Oral Captopril in Hypertensive Crisis.
abstract: BACKGROUND
  There are confusing data in literature regarding oral and sublingual captopril effects over blood pressure (BP) decrease.
  
  
  OBJECTIVE
  In our study we compared oral and sublingual captopril effectiveness over BP decrease in patients admitted to our Emergency Department with hypertensive urgency.
  
  
  METHODS
  Our study was conducted from January 2012 to January 2013 in patients with hypertensive urgency. In this cross-sectional study after two initial BP measurements, patients were identified as eligible for the study. An initial electrocardiogram was obtained and blood samples were drawn. A total of 212 patients were accepted as eligible for the study, and 25 mg of captopril was randomly given orally or sublingually; BP was measured at 10, 30, and 60 min. We selected the patients to the groups consecutively. A 25% reduction of initial BP 1 h after initiation of the treatment was accepted as an accomplishment. A second 25 mg of captopril was given if the target of 25% reduction of BP was not reached after the first tablet. Intravenous drugs were administered to the patients resistant to the captopril and these patients were excluded from the study.
  
  
  RESULTS
  The 10-min systolic BP (SBP), diastolic BP, and mean BP (MBP) decrease was more prominent in the sublingual captopril group (p < 0.001). This decrease was statistically significant in the SBP and MBP at 30 min (p < 0.001), and no statistical difference was recorded at 60 min (p > 0.05).
  
  
  CONCLUSIONS
  In our study, sublingual captopril was found to decrease BP more efficiently in the first 30 min, but this difference equalized at 60 min.
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Kaya
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Mustafa Adem
authors.initials: MA
authors.lastname: Tatlisu
authors.affiliation: Department of Clinical Pharmacology, Yeditepe University Faculty of Pharmacy, Istanbul, Turkey.
authors.forename: Tugba
authors.initials: T
authors.lastname: Kaplan Kaya
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Yildirimturk
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Baris
authors.initials: B
authors.lastname: Gungor
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Baran
authors.initials: B
authors.lastname: Karatas
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Yazici
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Keskin
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Sahin
authors.initials: S
authors.lastname: Avsar
authors.affiliation: Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Murat
mesh_terms: D000284:Administration, Oral; D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects*; D002216:Captopril / Q000008:administration & dosage* / Q000494:pharmacology; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D000959:Antihypertensive Agents; D002216:Captopril
keywords: hypertensive urgency; oral captopril; sublingual captopril