Systemic hypertension at emergency units. The use of symptomatic drugs as choice for management

Compare the therapeutic response of symptomatic, hypertensive patients to symptomatic medication or anti-hypertensive drugs at the Emergency Unit. A randomized, blind clinical trial involving 100 (one hundred) patients assisted at the Cardiology Emergency Unit at Oswaldo Cruz University Hospital (HUOC). All patients reported symptoms associated to systolic pressure (SBP) between 180 and 200 mmHg and/or diastolic pressure (DBP) between 110 and 120 mmHg. Patients were randomized for treatment with symptomatic (dipirone or diazepan) or anti-hipertensive drug (captopril). Those reporting any associated clinical condition and in need of immediate treatment at the Emergency Unit were excluded from the study. Patients reporting no symptoms, and systolic pressure reduced to levels under 180 mmHg and diastolic pressure under 110 mmHg after the 90-minute period were considered as having met discharge criteria. Mean age of population studied was 54.4 years old, most commonly females. Patients were chronic hypertensive, on irregular pharmacological treatment, with low compliance to non-pharmacologic actions, and classified as overweight and obese grade I. Headache, type D (non-angina) chest pain, and dyspnea were the most frequent complaints. The number of patients treated with symptomatic drug who reached discharge criteria was similar to that of patients treated with anti-hypertensive (p=0.165). No association was found between previous high blood pressure (HBP) diagnosis (p=0.192), pharmacological treatment (p=0.687), and non-pharmacological treatment and discharge criteria. Blood pressure (BP) was reduced below levels for discharge criteria for a (non-significant) higher rate of patients treated with symptomatic drug, who were turned into asymptomatic after the observation period.