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Comparison of intravenous urapidil and oral captopril in patients with hypertensive urgencies

Journal of Human Hypertension volume 20, pages 707–709 (2006)Cite this article

In a prospective, double-blinded, double-dummy, randomized study, 69 patients with a hypertensive urgency (systolic blood pressure (SBP) >220 mm Hg and/or diastolic blood pressure (DBP) >110 mm Hg) received either captopril or urapidil to reduce of SBP <180 mm Hg and DBP <90 mm Hg and blood pressure was measured by an ambulatory blood pressure unit for at least 12 h. The area-under-the-curve (AUC) of SBP and DBP was 163 (20)/85 (12) mm Hg for the urapidil group and 159 (17)/88 (9) mm Hg for the captopril group ( P -values 0.38/0.40) and the AUC above 180/90 mm Hg was 4.6 (4.9)/4.7 (5.7) mm Hg versus 2.7 (5.1)/5.3 (6.3) mm Hg ( P =0.12/ P =0.42) demonstrating that intravenous urapidil may be also an useful drug in the treatment of hypertensive urgencies.

Hypertensive urgencies are commonly observed in emergency departments and walk-in-clinics.1 The Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure as well as the International Society of Hypertension (ISH) recommended the use of oral agents for the treatment of hypertensive urgencies, as blood pressure reduction should occur from 6 to 24 h.2, 3 In the setting of an emergency department, a close follow-up of these patients is usually impossible. Therefore, many emergency departments have standard procedures that prohibit release of patients with blood pressure in excess of 180/110 mm Hg and treat patients with hypertensive urgencies using intravenous (i.v.) drugs like urapidil or labetalol.4, 5 These drugs reduce blood pressure sufficiently within a short time and with a low frequency of side effects.6 However, these procedures are controversially discussed and data demonstrating safety and efficacy of this treatment are lacking. We, therefore, aimed a study to evaluate the safety and efficacy of an i.v. antihypertensive drug compared to the standard oral treatment of patients with hypertensive urgencies.

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Authors and Affiliations

  1. Department of Emergency Medicine, University of Vienna, Vienna, Austria

    C Woisetschläger, A Bur, M Vlcek, U Derhaschnig & A N Laggner

  2. Department of Cardiology, III Medical Department, Central Clinicum, St Poelten, Austria

    M M Hirschl

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  1. C Woisetschläger
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  2. A Bur
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  3. M Vlcek
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  4. U Derhaschnig
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  5. A N Laggner
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  6. M M Hirschl
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Correspondence to M M Hirschl.

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Conflict of interest: None.

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Woisetschläger, C., Bur, A., Vlcek, M. et al. Comparison of intravenous urapidil and oral captopril in patients with hypertensive urgencies. J Hum Hypertens 20, 707–709 (2006). https://doi.org/10.1038/sj.jhh.1002063

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