Key result
Amlodipine and captopril demonstrated similar efficacy in managing uncontrolled blood pressure in the emergency department, achieving target blood pressure reductions in 53.2% and 53.8% of patients, respectively (p=0.543).
Why the study?
The study was conducted to compare the efficacy of amlodipine versus captopril for managing patients presenting to the emergency department with uncontrolled blood pressure.
Does amlodipine compared to captopril improve target blood pressure reduction in patients presenting to the emergency department with uncontrolled blood pressure?
RCT (n=127)
Open-label
Lottery
No
Does amlodipine compared to captopril improve target blood pressure reduction in patients presenting to the emergency department with uncontrolled blood pressure?
Oral amlodipine 10 mg and captopril 12.5 mg are similarly effective for acutely reducing uncontrolled blood pressure in the emergency department setting.
Comparable ED BP control with amlodipine or captopril; leaves open need for RCTs before practice change.
Objective: To compare the efficacy of Amlodipine with Captopril in the management of patients presenting to the emergency department with uncontrolled blood pressure. Study Design: Comparative prospective study. Place and Duration of Study: Emergency Department, Combined Military Hospital, Malir Pakistan, from Jul to Dec 2021. Methodology: A total of 127 individuals presenting to the Emergency Department with two readings of uncontrolled blood pressure (Systolic blood pressure ≥ 160mmHg and Diastolic blood pressure ≥90mmHg) were included. They were administered a tablet of Captopril 12.5mg per oral and a tablet of Amlodipine 10mg per oral on the turn by turn basis. Patients were observed for 3 hours and monitored for the reduction in blood. The efficacy of medication was judged based on the ability to achieve target blood pressure reduction, which was at least a 20-30% reduction in systolic blood pressure. Results: Out of 127 individuals, 65(51.2%) patients were given a tablet of Captopril 12.5mg orally, and 62(48.8%) were given a tablet of Amlodipine 10mg orally. The mean reduction in systolic blood pressure was 20.73±5.17 in all patients. In addition,target blood pressure reduction was achieved in 35(53.8%) individuals of the Captopril-Group and 33(53.2%) of the Amlodipine-Group, with a total of 68(53.5%) individuals achieving target blood pressure within 3 hours after medication. Conclusion: Both medications were efficient in achieving target blood pressure levels. However, no drug was superior to another in reducing blood pressure in an emergency.
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Mansoor et al. (2023) conducted an RCT in Uncontrolled blood pressure (n=127). Amlodipine vs. Captopril 12.5 mg orally was evaluated on Target blood pressure reduction (at least 20-30% reduction in systolic blood pressure) (p=0.543). Amlodipine and captopril demonstrated similar efficacy in managing uncontrolled blood pressure in the emergency department, achieving target blood pressure reductions in 53.2% and 53.8% of patients, respectively (p=0.543).
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