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Colegio de Medicina Interna de México.

2007, Number 2

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Med Int Mex 2007; 23 (2)

Equivalence study between sublingual isosorbide dinitrate and nifedipine to control hypertensive emergency

Martínez MJA, Velasco RVM, Esquivel MCG, Chávez LL

Language: Spanish
References: 34
Page: 101-105
PDF size: 139.42 Kb.


ABSTRACT

Objective: To determine that isosorbide dinitrate has the same efficacy than nifedipine when administered sublingually for the control of the hypertensive emergency.
Patient and methods: Blind equivalence trial done at the Zone General Hospital no. 16, from the Instituto Mexicano del Seguro Social, Torreon, Coahuila, Mexico. Services of emergency and internal medicine participated from January to September, 2001. Sixty patients were included with criteria of hypertensive emergency with media blood pressure ≥ 130 mmHg and two minor symptoms; patients were divided randomly in two groups of 30. One group was given isosorbide dinitrate and the other nifedipine. In both groups initial electrocardiogram and an hour later was done, as well as monitoring of the arterial pressure every 15 minutes during the first hour and then each hour during four hours.
Results: Isosorbide group had a reduced blood pressure 183/114 to 130/81 (p ‹ 0.005), with basal media blood pressure of 137.8 to 97.6 mmHg. In the nifedipine group blood pressure was of 182/112 to 123/78 mmHg (p ‹ 0.005), with basal media blood pressure of 136.7 to 92.75 mmHg. In any group severe side effects were recorded; chi square test was not significant; there were no changes in the heart rate or rebound hypertension in any patient.
Conclusions: Isosorbide dinitrate is effective in the treatment of patients with hypertensive emergency, as well as nifedipine; although with a higher safety margin; thus nitric oxide donors are an alternative in the treatment of hypertensive emergencies.


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