Comparison of the effects of furosemide, captopril and lorazepam on noncomplicated hypertensive patients in the emergency department

Introduction

Patients frequently refer to the emergency department with hypertension and related disorders. If hypertensive crisis is not diagnosed in these patients, urgent treatment is not necessary. However, taking patient satisfaction into consideration, the emergency physicians usually discharge these patients after lowering the blood pressure with various medications [1]. This prospective, randomized, placebo-controlled study is designed in order to compare the effects of captopril, furosemide and lorazepam on lowering blood pressure and increasing patient satisfaction.

Methods

One hundred patients with uncomplicated hypertension were included in the study. All were randomized into four groups: (1) captopril group, (2) furosemide group, (3) lorazepam group, (4) placebo group. The blood pressure was measured at baseline, 30th, 60th and 90th minute. The patient satisfaction was assessed with a visual analog scale (VAS) at baseline and 90th minute.

Results

Captopril (23.64 mmHg), lorazepam (24.90 mmHg) and furosemide (24.10 mmHg) were found similarly effective in lowering blood pressure when we compare baseline and 90th minute, but all three drugs were superior to placebo (15.94 mmHg) (P < 0.05) (Table 1). When patient satisfaction was assessed with the VAS, captopril (30.12 mm), furosemide (28.04 mm) and lorazepam (32.88 mm) were statistically similar and all three drugs were superior to placebo (22.76 mm).

Table 1 Mean arterial pressure

Conclusions

In conclusion, all three drugs can be used in subjects referred to the emergency department with uncomplicated hypertension. They are similarly effective in both lowering the blood pressure and increasing patient satisfaction.