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Journal of the Korean Academy of Family Medicine 1988;9(7):14-21.
Published online July 1, 1988.
급성 중증 고혈압에서 Nifedipine 설하투여의 강압효과에 관한 연구
신호철 조성일 조정진 임현술 허봉렬
서울대학교병원 가정의학과
Hypertensive emergencies are situations in which greatly elevated blood pressure must be lowered within 1 hour to reduce actual patient risk, whereas urgencies are situations where severe elevations in blood pressure are not causing immediate end-organ damage but should be controlled within 24 hours to reduce potential patient risk. In this report the efficacy and safety of sublingual nifedipine were evaluated in 36 patients, 14 men and 22 women, aged 27 to 76 years who had acute severe hypertension. Before treatment mean systolic blood pressure(SBP) was 204.7±28.5 mmHg, mean diastolic blood pressure(DBP) was 121.7±16.5mmHg, average mean arterial blood pressure(MBP) was 148.4±19.1mmHg, and mean pulse rate(PR) was 75.3±18.3 beats/minute. AT 30 minutes after administration of 10mg of sublingual nifedipine, the decreases in the SBP, DBP, and MBP for the group were 48.1±25.4mmHg, 23.6±18.2mmHg, 32.6±18.0mmHg respectively, all of which were highly significant(P<0.01). The another group of patients who were 9 men and 17 women, aged 37 to 74 years, and also had acute severe hypertension were treated with hydralazine to compare with the efficacy and safety of nifedipine. Before treatment SBP, DBP, MBP, and PR were 205.4±25.3 mmHg, 124.8±19.1 mmHg, 152.3±18.7 mmHg, and 76.0±12.7 beats/minute respectively. This two groups of patients had no significant differences in the demographic characteristics and clinical data. At 30 minutes after administration of 10 mg of hydralazine parenterally, the decreases in SBP, DBP, and MBP for the group were 32.3±22.7 mmHg, 21.5±18.7 mmHg, 24.1±19.3 mmHg, respectively, all of which were highly significant(P<0.01). With the comparison of fall in blood pressure between hydralazine treated group and nifedipine treated group, 10 mg of nifedipine produced a significantly greater angihypertensive effect than 10 mg of hydralazine(48.1±25.4 mmHg vs. 32.3±22.7 mmHg SBP, P<0.01, 23.6±18.2 mmHg vs. 21.5±18.7 mmHg DBP, P<0.05, 32.6±18.0 mmHg, 24.1±19.3 mmHg MBP, P<0.01). The response to nifedipine correlated with the blood pressure value prior to treatment, but did not correlated with age, gender or the type of hypertensive emergency and urgency. The side effects noted after use of nifedipine were headache in 3 patients, dizziness in 1 patient.
These results syggest that sublingual nifedipine is a safe, effective, and practical agent for treating patients with acute severs hypertension, and may be used in an OPD setting as a first-line drug.
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