A combination of low-dose oral enalapril, methyldopa and hydrochlorothiazide was evaluated in the acute treatment of severe hypertension. Blood pressure moved from an average 210/120 mmHg at the onset to an average 135/79 mmHg within 24 hours, without any significant side effects and at about half the cost of commonly used parenteral hydralazine.
Get full access to this article
View all access options for this article.
References
1.
Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure. The sixth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. (JNC VI). Arch Intern Med1997; 157: 2413–46.
2.
McKenzieClark R. Hypertension. In: CareyFCLeeHHWoeltjeKE, eds. The Washington Manual of Medical Therapeutics, 29th edn. Philadelphia: Lippincott-Raven, 1998: 61–80.
3.
1999 World Health Organization International Society of Hypertension guidelines for the management of hypertension. J Hypertension1999; 17: 151–83.
4.
RamsayLEUl-Haq-IYeoWWJacksonPR. Interpretation of prospective trials in hypertension: Do treatment guidelines accurately reflect current evidence?. J Hypertension1996; 14 (suppl): S187–94.
5.
KarnikNDBhattADTrivediTH. Nifedipine, Captopril, metoprolol, and nifedipine with metoprolol in hypertensive crisis in a non-intensive care setting. J Assoc Physicians India1996; 44: 480–2.
6.
JagasothyRParanthamanS. Sublingual nifedipine compared with intravenous hydralazine in the acute treatment of severe hypertension in pregnancy: Potential for use in rural practice. J Obstet Gynaecol Res1996; 22: 21–4.
7.
DamascenoASeveneEPatelSPoloniaJ. Nifedipine-retard versus nifedipine capsules for the therapy of hypertensive crisis in black patients. J Cardiovasc Pharmacol1998; 31: 165–9.
8.
HellerMBDudaJMahaRJ. Prehospital use of nifedipine for severe hypertension. Am J Emerg Med1990; 8: 282–4.
9.
GreeneCSGretlerDDCervenkaKMcCoyCEBrownFDMurphyMB. Cerebral blood flow during the acute therapy of severe hypertension with oral Clonidine. Am J Emerg Med1990; 8: 293–6.
10.
GoaKLWagstaffAJ. Losartan potassium: A review of its pharmacology, clinical efficacy and tolerability in the management of hypertension. Drugs1996; 53: 540.
11.
StimpelMKochBDicksteinK. Moexipril as add-on therapy to hydrochlorothiazide in moderate to severe hypertension. Cardiology1996; 87: 313–18.
AjayiAAAfolabiMABalogunMOAdigunAQAjayiOEAkintomideAO. Oral therapy with combined enalapril, prazosin and hydrochlorothiazide in the acute treatment of severe hypertension in Nigerians. Eur J Clin Pharmacol1996; 51: 45–8.
14.
LeonettiGCuspidiCSampieriL. Evaluation of the efficacy and safety of enalapril plus hydrochlorothiazide plus methyldopa vs standard triple therapy in the treatment of moderate to severe hypertension: Results from a multicentre study. J Hum Hypertens1990; 4: 5–11.
