On the practice of rapid blood pressure reduction with oral medications. A scientific view

Contrary to modern guidelines for the treatment of hypertension, oral and sublingual antihypertensive medications are often used in real-world practice to quickly reduce asymptomatic or low-symptom elevated blood pressure (BP). Doctors and patients explain this by the need to "stop an uncomplic...

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Main Authors: A. D. Erlikh, A. V. Rodionov, I. S. Yavelov, D. Yu. Shchekochikhin, V. V. Kashtalap, S. Yu. Martsevich, S. T. Matskeplishvili
Format: Article
Language:Russian
Published: «SILICEA-POLIGRAF» LLC 2025-03-01
Series:Кардиоваскулярная терапия и профилактика
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Online Access:https://cardiovascular.elpub.ru/jour/article/view/4197
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author A. D. Erlikh
A. V. Rodionov
I. S. Yavelov
D. Yu. Shchekochikhin
V. V. Kashtalap
S. Yu. Martsevich
S. T. Matskeplishvili
author_facet A. D. Erlikh
A. V. Rodionov
I. S. Yavelov
D. Yu. Shchekochikhin
V. V. Kashtalap
S. Yu. Martsevich
S. T. Matskeplishvili
author_sort A. D. Erlikh
collection DOAJ
description Contrary to modern guidelines for the treatment of hypertension, oral and sublingual antihypertensive medications are often used in real-world practice to quickly reduce asymptomatic or low-symptom elevated blood pressure (BP). Doctors and patients explain this by the need to "stop an uncomplicated hypertensive crisis" for preventing cardiovascular events. Clinical trial data indicate that such an approach, both the prescription of short-­acting drugs at an outpatient or inpatient levels, and recommendations for self-treatment of hypertension, not only does not benefit the patient, but is also likely to be associated with an increased risk of cardiovascular events. Shifting the focus of hypertension treatment from improving the long-term prognosis to immediate BP reduction may increase short-term variability of BP, which is a possible mechanism for the development of complications when using fast-acting oral antihypertensives. The article substantiates the unacceptability of emergency BP reduction with oral and sublingual antihypertensive drugs. It describes rational actions of a physician in case of detection of asymptomatic or low-symptom BP increase in a patient and presents possible approaches to home BP self-monitoring in accordance with modern clinical guidelines. It also describes the management of true hypertensive crises depending on the characteristics of hypertension-­mediated organ damage.
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series Кардиоваскулярная терапия и профилактика
spelling doaj-art-d0b5a49cba3645e1b4e997f026a35ebe2025-08-20T02:59:14Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252025-03-0124110.15829/1728-8800-2025-41973171On the practice of rapid blood pressure reduction with oral medications. A scientific viewA. D. Erlikh0A. V. Rodionov1I. S. Yavelov2D. Yu. Shchekochikhin3V. V. Kashtalap4S. Yu. Martsevich5S. T. Matskeplishvili6AO Ilyinskaya Hospital; Pirogov Russian National Research Medical UniversitySechenov First Moscow State Medical UniversityNational Medical Research Center for Therapy and Preventive MedicineAO Ilyinskaya Hospital; Sechenov First Moscow State Medical University.Research Institute for Complex Issues of Cardiovascular DiseasesNational Medical Research Center for Therapy and Preventive MedicineLomonosov Moscow State UniversityContrary to modern guidelines for the treatment of hypertension, oral and sublingual antihypertensive medications are often used in real-world practice to quickly reduce asymptomatic or low-symptom elevated blood pressure (BP). Doctors and patients explain this by the need to "stop an uncomplicated hypertensive crisis" for preventing cardiovascular events. Clinical trial data indicate that such an approach, both the prescription of short-­acting drugs at an outpatient or inpatient levels, and recommendations for self-treatment of hypertension, not only does not benefit the patient, but is also likely to be associated with an increased risk of cardiovascular events. Shifting the focus of hypertension treatment from improving the long-term prognosis to immediate BP reduction may increase short-term variability of BP, which is a possible mechanism for the development of complications when using fast-acting oral antihypertensives. The article substantiates the unacceptability of emergency BP reduction with oral and sublingual antihypertensive drugs. It describes rational actions of a physician in case of detection of asymptomatic or low-symptom BP increase in a patient and presents possible approaches to home BP self-monitoring in accordance with modern clinical guidelines. It also describes the management of true hypertensive crises depending on the characteristics of hypertension-­mediated organ damage.https://cardiovascular.elpub.ru/jour/article/view/4197hypertensionhypertensive crisishypertensive emergencyblood pressurerapid reductionblood pressure measurement
spellingShingle A. D. Erlikh
A. V. Rodionov
I. S. Yavelov
D. Yu. Shchekochikhin
V. V. Kashtalap
S. Yu. Martsevich
S. T. Matskeplishvili
On the practice of rapid blood pressure reduction with oral medications. A scientific view
Кардиоваскулярная терапия и профилактика
hypertension
hypertensive crisis
hypertensive emergency
blood pressure
rapid reduction
blood pressure measurement
title On the practice of rapid blood pressure reduction with oral medications. A scientific view
title_full On the practice of rapid blood pressure reduction with oral medications. A scientific view
title_fullStr On the practice of rapid blood pressure reduction with oral medications. A scientific view
title_full_unstemmed On the practice of rapid blood pressure reduction with oral medications. A scientific view
title_short On the practice of rapid blood pressure reduction with oral medications. A scientific view
title_sort on the practice of rapid blood pressure reduction with oral medications a scientific view
topic hypertension
hypertensive crisis
hypertensive emergency
blood pressure
rapid reduction
blood pressure measurement
url https://cardiovascular.elpub.ru/jour/article/view/4197
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