Clinical efficacy of sublingual captopril in the treatment of hypertensive urgency

Kazerani H, Hajimoradi B, Amini A, Naseri MH, Moharamzad Y
Correspondence: Dr Yashar Moharamzad, yasharpop@hotmail.com

ABSTRACT
Introduction This study aimed to evaluate the response rate, clinical efficacy and onset of action of sublingual captopril in patients diagnosed with hypertensive urgency.
Methods In this cross-sectional study, 101 (67 female and 34 male) patients with a diagnosis of hypertensive urgency (systolic pressure greater than or equal to 180 mmHg and/or diastolic pressure greater than or equal to 110 mmHg, and no findings of target organ damage) were included. Sublingual captopril (25 mg) was administered and the blood pressure was measured during a follow-up period of 120 minutes.
Results After 60 minutes, an ideal decrease (25 percent of the initial blood pressure) was detected in 54 patients (53.5 percent). An additional 25 mg of sublingual captopril was administered to the remaining 47 patients (46.5 percent). Of these, 19 (18.8 percent) did not respond even to the second dose of sublingual captopril. These non-responders consisted of patients who were taking multidrug antihypertensive regimens before presentation due to hypertensive urgency. No serious side effect was recorded during the study period.
Conclusion Sublingual captopril can be used as an effective, easily applicable and safe treatment in the management of hypertensive urgency for 120 minutes for those who do not receive multidrug antihypertensive regimens.

Keywords: captopril, hypertension, hypertensive urgency, sublingual captopril
Singapore Med J 2009; 50(4): 400-402