| Am J Hypertens. 2005 Sep;18(9):1174-7 |
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| Antianxiety treatment in patients with excessive hypertension. |
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| Grossman E, Nadler M, Sharabi Y, Thaler M, Shachar A, Shamiss A |
|
| Internal Medicine D and the Hypertension Unit, The Chaim Sheba Medical
Center, Tel-Hashomer, Tel Aviv University, Sackler School of Medicine,
Israel |
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| OBJECTIVE: There are no guidelines on how to treat patients with
excessive hypertension. Anxiety is a common cause of excessive hypertension
and therefore antianxiety treatment may be beneficial in these patients.
We therefore compared the efficacy and safety of antianxiety treatment
with sublingual CAPTOPRIL administration
in patients with excessive hypertension and no evidence of acute target
organ damage. METHODS: Thirty-six patients (28 women and 8 men), mean
age 60 +/- 2 years (range 36 to 85 years) who were referred to the
emergency room because of excessive hypertension (>190/100 mm Hg)
without evidence of acute target organ damage were randomized to receive
either oral DIAZEPAM,
5 mg (n = 17, study group) or sublingual CAPTOPRIL,
25 mg (n = 19, control group). Blood pressure (BP) and heart rate were
recorded hourly for 3 h. RESULTS: Both treatments decreased BP significantly
(from 213 +/- 5/105 +/- 3 to 170 +/- 8/88 +/- 6 mm Hg in the study
group, and from 208 +/- 5/107 +/- 3 to 181 +/- 8/95 +/- 3 mm Hg in
the control group (P < .01 v initial BP). One patient in each group
was hospitalized because of sustained excessive hypertension. CONCLUSIONS:
Antianxiety treatment is effective in lowering BP in patients with
excessive hypertension. Thus, anxiolytic treatment may be considered
in patients with excessive hypertension without acute target organ
damage. Further large placebo controlled studies are required to prove
the benefit of anxiolytic agents. |
