Sublingual isosorbide dinitrate in the acute control of hypertension in patients with severe preeclampsia

The objective of this study was to evaluate the effectiveness of sublingual isosorbide dinitrate (ID) in the acute control of hypertension in patients with severe preeclampsia. A randomized, double-blind clinical trial with a preinclusion period of response to hydration and rest was performed in 60 patients with severe preeclampsia. The treatment group (30 patients) receiv ed 5 mg of sublingual ID, a dose that could be repeated on a second occasio n. The control group consisted of 30 patients who received placebo. Both gr oups continued with rest and hydration during the study. Maternal blood pre ssure and fetal heart rate were measured in all patients every 10 min until 1 h was completed. Treatment was considered effective when the diastolic b lood pressure could be reduced to between 80 and 100 mm Hg. ID was effectiv e in 56.6% of the patients in the first 10 min after its administration and in 96.6% from 40 to 60 min. In the treatment group the systolic a nd diast olic blood pressures dropped gradually from 171 +/- 13 and 113 +/- 8 mm Hg, respectively, to 136 +/- 14 and 87 +/- 9 mm Hg. In the placebo group, bloo d pressure was not reduced. There was no significant difference in fetal he art: rate between both groups throughout the study. In conclusion, ID was s hown to be effective in the acute control of hypertension in patients with severe preeclampsia, where high blood pressure persists after a period of r est and hydration. Copyright (C) 2000 S. Karger AG. Basel.