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. Objectives In our study we compared oral and sublingual captopril effectiveness over BP decrease in patients admitted to our Emergency Department with hyperte...
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| Veröffentlicht in: | The Journal of emergency medicine 2016-01, Vol.50 (1), p.108-115 |
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| creator | Kaya, Adnan, MD Tatlisu, Mustafa Adem, MD Kaplan Kaya, Tugba, Pharm Yildirimturk, Ozlem, MD Gungor, Baris, MD Karatas, Baran, MD Yazici, Selcuk, MD Keskin, Muhammed, MD Avsar, Sahin, MD Murat, Ahmet, MD |
| description | Abstract Background There are confusing data in literature regarding oral and sublingual captopril effects over blood pressure (BP) decrease. Objectives 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 |
| doi_str_mv | 10.1016/j.jemermed.2015.07.017 |
| format | Article |
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Objectives 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.</description><identifier>ISSN: 0736-4679</identifier><identifier>EISSN: 2352-5029</identifier><identifier>DOI: 10.1016/j.jemermed.2015.07.017</identifier><identifier>PMID: 26409670</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Administration, Oral ; Administration, Sublingual ; Adult ; Aged ; Antihypertensive Agents - administration & dosage ; Antihypertensive Agents - pharmacology ; Blood Pressure - drug effects ; Captopril - administration & dosage ; Captopril - pharmacology ; Cross-Sectional Studies ; Emergency ; Female ; Heart Rate - drug effects ; Humans ; Hypertension - drug therapy ; hypertensive urgency ; Male ; Middle Aged ; oral captopril ; sublingual captopril</subject><ispartof>The Journal of emergency medicine, 2016-01, Vol.50 (1), p.108-115</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c493t-c2f7296872c5481b822466ebf417b2895888ce81badc97f1baf61d725c8e197c3</citedby><cites>FETCH-LOGICAL-c493t-c2f7296872c5481b822466ebf417b2895888ce81badc97f1baf61d725c8e197c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jemermed.2015.07.017$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26409670$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kaya, Adnan, MD</creatorcontrib><creatorcontrib>Tatlisu, Mustafa Adem, MD</creatorcontrib><creatorcontrib>Kaplan Kaya, Tugba, Pharm</creatorcontrib><creatorcontrib>Yildirimturk, Ozlem, MD</creatorcontrib><creatorcontrib>Gungor, Baris, MD</creatorcontrib><creatorcontrib>Karatas, Baran, MD</creatorcontrib><creatorcontrib>Yazici, Selcuk, MD</creatorcontrib><creatorcontrib>Keskin, Muhammed, MD</creatorcontrib><creatorcontrib>Avsar, Sahin, MD</creatorcontrib><creatorcontrib>Murat, Ahmet, MD</creatorcontrib><title>Sublingual vs. Oral Captopril in Hypertensive Crisis</title><title>The Journal of emergency medicine</title><addtitle>J Emerg Med</addtitle><description>Abstract Background There are confusing data in literature regarding oral and sublingual captopril effects over blood pressure (BP) decrease. Objectives 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.</description><subject>Administration, Oral</subject><subject>Administration, Sublingual</subject><subject>Adult</subject><subject>Aged</subject><subject>Antihypertensive Agents - administration & dosage</subject><subject>Antihypertensive Agents - pharmacology</subject><subject>Blood Pressure - drug effects</subject><subject>Captopril - administration & dosage</subject><subject>Captopril - pharmacology</subject><subject>Cross-Sectional Studies</subject><subject>Emergency</subject><subject>Female</subject><subject>Heart Rate - drug effects</subject><subject>Humans</subject><subject>Hypertension - drug therapy</subject><subject>hypertensive urgency</subject><subject>Male</subject><subject>Middle Aged</subject><subject>oral captopril</subject><subject>sublingual captopril</subject><issn>0736-4679</issn><issn>2352-5029</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkTtPwzAQgC0EglL4CygjS8LZSfxYEKgCilSJAZitxLkghzQpdlKp_x5HbRcWprN03z38HSE3FBIKlN81SYNrdGusEgY0T0AkQMUJmbE0Z3EOTJ2SGYiUxxkX6oJcet9AIEDSc3LBeAaKC5iR7H0sW9t9jUUbbX0SvbnwWBSbod8420a2i5a7DboBO2-3GC2c9dZfkbO6aD1eH-KcfD4_fSyW8ert5XXxuIpNptIhNqwWTHEpmMkzSUvJWMY5lnVGRcmkyqWUBkOiqIwSdYg1p5VguZFIlTDpnNzu-25c_zOiH_TaeoNtW3TYj15TkacAUlAVUL5Hjeu9d1jrsP-6cDtNQU_GdKOPxvRkTIPQwUcovDnMGMspdyw7KgrAwx7A8NOtRae9sdgZrKxDM-iqt__PuP_TwgTn1hTtN-7QN_3ouuBRU-2ZBv0-3W06G80BhGI0_QWFYZOC</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Kaya, Adnan, MD</creator><creator>Tatlisu, Mustafa Adem, MD</creator><creator>Kaplan Kaya, Tugba, Pharm</creator><creator>Yildirimturk, Ozlem, MD</creator><creator>Gungor, Baris, MD</creator><creator>Karatas, Baran, MD</creator><creator>Yazici, Selcuk, MD</creator><creator>Keskin, Muhammed, MD</creator><creator>Avsar, Sahin, MD</creator><creator>Murat, Ahmet, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Sublingual vs. Oral Captopril in Hypertensive Crisis</title><author>Kaya, Adnan, MD ; Tatlisu, Mustafa Adem, MD ; Kaplan Kaya, Tugba, Pharm ; Yildirimturk, Ozlem, MD ; Gungor, Baris, MD ; Karatas, Baran, MD ; Yazici, Selcuk, MD ; Keskin, Muhammed, MD ; Avsar, Sahin, MD ; Murat, Ahmet, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c493t-c2f7296872c5481b822466ebf417b2895888ce81badc97f1baf61d725c8e197c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Administration, Oral</topic><topic>Administration, Sublingual</topic><topic>Adult</topic><topic>Aged</topic><topic>Antihypertensive Agents - administration & dosage</topic><topic>Antihypertensive Agents - pharmacology</topic><topic>Blood Pressure - drug effects</topic><topic>Captopril - administration & dosage</topic><topic>Captopril - pharmacology</topic><topic>Cross-Sectional Studies</topic><topic>Emergency</topic><topic>Female</topic><topic>Heart Rate - drug effects</topic><topic>Humans</topic><topic>Hypertension - drug therapy</topic><topic>hypertensive urgency</topic><topic>Male</topic><topic>Middle Aged</topic><topic>oral captopril</topic><topic>sublingual captopril</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kaya, Adnan, MD</creatorcontrib><creatorcontrib>Tatlisu, Mustafa Adem, MD</creatorcontrib><creatorcontrib>Kaplan Kaya, Tugba, Pharm</creatorcontrib><creatorcontrib>Yildirimturk, Ozlem, MD</creatorcontrib><creatorcontrib>Gungor, Baris, MD</creatorcontrib><creatorcontrib>Karatas, Baran, MD</creatorcontrib><creatorcontrib>Yazici, Selcuk, MD</creatorcontrib><creatorcontrib>Keskin, Muhammed, MD</creatorcontrib><creatorcontrib>Avsar, Sahin, MD</creatorcontrib><creatorcontrib>Murat, Ahmet, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kaya, Adnan, MD</au><au>Tatlisu, Mustafa Adem, MD</au><au>Kaplan Kaya, Tugba, Pharm</au><au>Yildirimturk, Ozlem, MD</au><au>Gungor, Baris, MD</au><au>Karatas, Baran, MD</au><au>Yazici, Selcuk, MD</au><au>Keskin, Muhammed, MD</au><au>Avsar, Sahin, MD</au><au>Murat, Ahmet, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sublingual vs. Oral Captopril in Hypertensive Crisis</atitle><jtitle>The Journal of emergency medicine</jtitle><addtitle>J Emerg Med</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>50</volume><issue>1</issue><spage>108</spage><epage>115</epage><pages>108-115</pages><issn>0736-4679</issn><eissn>2352-5029</eissn><abstract>Abstract Background There are confusing data in literature regarding oral and sublingual captopril effects over blood pressure (BP) decrease. Objectives 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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26409670</pmid><doi>10.1016/j.jemermed.2015.07.017</doi><tpages>8</tpages></addata></record> |
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| ispartof | The Journal of emergency medicine, 2016-01, Vol.50 (1), p.108-115 |
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| subjects | Administration, Oral Administration, Sublingual Adult Aged Antihypertensive Agents - administration & dosage Antihypertensive Agents - pharmacology Blood Pressure - drug effects Captopril - administration & dosage Captopril - pharmacology Cross-Sectional Studies Emergency Female Heart Rate - drug effects Humans Hypertension - drug therapy hypertensive urgency Male Middle Aged oral captopril sublingual captopril |
| title | Sublingual vs. Oral Captopril in Hypertensive Crisis |
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