35. Sublingual Versus Oral Captopril for Blood Pressure Reduction in Hypertensive Urgency: A Systematic Review

Abstract

Background: Hypertensive emergencies are distinguished from hypertensive urgencies by the presence of immediately escalating target organ damage. The treatment of emergency hypertension should focus on bringing the blood pressure down gradually in 24 hours. Well known Guidelines recommend intravenous antihypertensive in this clinical setting. However, in some cases such as rural areas, oral antihypertensives are the one and only available option. Objective: To evaluate the which Captopril intake - the widely available oral anti-hypertensive agent in rural areas - that would have better outcome in Emergency Hypertension. Method: This review was conducted in accordance with the requirements outlined in the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines. The search for studies to be included in the systematic review was carried out from December, 28nd 2022 using the PubMed and SagePub databases by inputting the words: “sublingual”, “oral”, “captopril”, “blood pressure reduction” and “hypertension urgency”. Result: After identifying 1.254 PubMed and 897 SagePub articles, the total article that met publishing time criteria (2012 and after) are 190 articles. After performing tittle screening, 37 articles were chosen and when final exclusion criteria were applied, we have 4 articles left. The study showed that patients who received captopril subligual 25 mg experienced the greatest reduction in systolic blood pressure, while DBP and MAP were better in the oral group. Conclusion: Since the MAP reduction is the main therapy target in emergency hypertension, oral captopril intake is better than sublingual to achieve this goal.