ARRESTING OF COMPLICATED HYPERTENSIVE CRISES IN THE PHYSICIAN’S PRACTICE: URAPIDIL VALUE AND STUDY RESULTS

Aim. To compare the efficacy and safety of urapidil (i/v solution 5 mg/ml in 5 and 10 ml ampoules) and enalaprilat (i/v solution 1.25 mg/ml in 1 ml ampoules) in the treatment of complicated hypertensive crises in patients with arterial hypertension, 1-3 degrees. Material and methods. Patients with complicated hypertensive crisis (n=70) were included into the comparative randomized study. Patients were randomized for treatment with urapidil (the initial dose 12.5 mg; if there was no effect after 15 minutes it was possible to re-infused urapidil 12.5 mg) or enalaprilat (the initial dose 1.25 mg). The frequency of target blood pressure (BP) achievement, BP and heart rate dynamics, as well as safety of treatment were evaluated in groups during 6 hours. Results. The frequency of target BP achievement in the urapidil treatment group was higher than this in enalaprilat group (96.7 vs 73.3%; p<0.001), for the first hour systolic BP (SBP) in the urapidil group reduced from 210.5±13.6 to 157.8±8.3 mmHg (p<0.05), and diastolic BP (DBP) - from 115.7±8.5 to 86.9±9.1 mmHg (p<0.05). In the enalaprilat group in the first hour SBP reduced from 208.1 to 182.5 mmHg (p<0.05), DBP — from 114.8 to 95.0 mmHg (p<0.05). During next 6 hours the urapidil group demonstrated longer lasting antihypertensive effect in comparison with enalaprilat. Both drugs did not have a significant effect on heart rate and showed no significant adverse events. In next 72 hours no one acute vascular event was registered in the patients of both groups. Conclusion. Urapidil is an effective and safe drug for arresting of complicated hypertensive crises. Its efficacy is not inferior to this of enalaprilat.