Hypertensive urgencies are a frequent cause for consultation at the emergency department (ED). There are multiple approaches to treating this presentation, and we endeavored to assess the safety and efficacy of an oral treatment with 10 mg of ramipril and 12.5 mg of hydrochlorothiazide to treat hypertensive urgencies (which we define as systolic blood pressure of N180 mmHg and/or diastolic blood pressure of N120 mmHg with absence of acute target organ disease in the ED) [1].

We enrolled 620 patients with hypertensive urgency prospectively and consecutively in our study. The mean age was 61.4 ± 10.7 years, 50% of patients were male, and 80% of the total number of patients had diagnosis of hypertension.

All patients were discharged from the ED with 10 mg of ramipril and 12.5 mg of hydrochlorothiazide when the systolic blood pressure was b160 mmHg and/or diastolic blood pressure was b100 mmHg [2]. There were no adverse events reported; 87% of patients were discharged after 3 ± 1.2 hours upon arrival at the ED, but 13% of patients were admitted into the coronary care unit to receive intravenous treatment [3,4].

We have concluded that 10 mg of ramipril and 12.5 mg of hydrochlorothiazide can be a safe and effective treatment for hypertensive urgency in the ED.