Nifedipine, captopril or sublingual nitroglycerin, which can reduce blood pressure the most?

BACKGROUND: Hypertension (HTN) is one of the most important problems in all parts of the world. Although the disease is usually asymptomatic, its diagnosis and treatment are easy. The aim of this study was to compare the effect of Nifedipine (Adalat®), Captopril and sublingual Nitroglycerin on reducing blood pressure (BP). METHODS: This study was a parallel group randomized controlled trial. From the patients referred to our heart clinic, ۱۲۰ patients with severe HTN were enrolled in the study. The patients were randomly allocated into ۳ groups A, B, and C. The patients were advised to use ۵ drops of Adalat in group A, Captopril ۲۵ mg sublingually in group B, and ۱ sublingual Nitroglycerin pearl in group C. The BP was measured every ۲۰ minutes during one hour. RESULTS: Systolic BP was reduced significantly by Adalat and Captopril compared with sublingual Nitroglycerin in the ۲۰th, ۴۰th and ۶۰th minutes (P = ۰.۰۰۱), but there was no significant difference between Adalat and captopril in reducing systolic BP. In addition, the result of reducing diastolic BP was not significantly different among the three groups. CONCLUSION: We saw the same effect on reducing BP by Captopril, Adalat, and sublingual Nitroglycerin. Among these three drugs, the side effects of Captopril were the least frequent. Adalat caused headache and flushing. Thus, it seems Captopril can be used instead of Adalat in medical centers. Keywords: Adalat, Captopril, Nitroglycerin, Severe Hypertension