Comparative efficacy of carvedilol and capoten in the treatment of an uncomplicated hypertensive crisis

AIM: Efficacy and tolerability of carvedilol vs captopril were studied at 24-h monitoring of blood pressure (BP) in hypertensive patients with an uncompletated hypertensive crisis (HC). MATERIAL AND METHODS: The trial included 43 patients (23 males and 20 females aged 58 +/- 4.1 years) with an uncomplicated HC (duration of hypertension 9.4 +/- 1.1 years). Twenty patients of group 1 received oral carvedilol (25 mg), 23 patients of group 2--oral captopril (25 mg). The criterion of efficacy was a 15-25% decrease of BP within 60-120 min. RESULTS: Attenuation of HC symptoms and tolerability was the same in both groups. Forty five minutes after the drug intake systolic pressure lowered by 11.1% (p = 0.039) and 10.9% (p = 0.042) in group 1 and 2, respectively; diastolic pressure--by 14.9% (p = 0.037) and 17.9% (p = 0.018), respectively. Heart rate diminished significantly only in group 1 (by 10.9%, p = 0.043) 30 min after carvedilol intake. A maximal BP fall in group 1 occurred 180 min after the drug intake: systolic by 23.5% (p = 0.0001), diastolic by 26.9% (p < 0.0001). In group 2 the BP fall was 23.3% (p < 0.0001) and 29.1% (p < 0.0001) on min 165 and 150, respectively. Systolic and diastolic pressures lowered faster in group 1. The effect of carvedilol lasted longer--372.6 +/- 19.3 min and 245.1 +/- 13.7 min, respectively, p = 0. 0001. CONCLUSION: A hypotensive effect of carvedilol and captopril in hypertensive patients with an uncomplicated HC was the same. Carvedilol produced a longer and a more stable effect.