Captopril, an ACE inhibitor, is widely used for acute hypertensive episodes, while hydroxyzine, an antihistamine with sedative and anxiolytic effects, is also employed in Poland despite limited research on its efficacy for this purpose. o our knowledge, no prior studies have specifically investigated the direct impact of hydroxyzine on hypertension, despite its common use in Polish medical practice. A retrospective cohort analysis of 2144 patients who required emergency intervention for hypertension or had high blood pressure during other interventions. Effectiveness was based on blood pressure improvement post-intervention. 84.28% of interventions were performed by basic emergency teams, and 15.72% by specialist teams. Captopril and hydroxyzine were the most commonly used medications. Blood pressure improved in 36.61% of patients, with no improvement in 41.47%. Hydroxyzine was more frequently administered by paramedic teams, while captopril was favored by specialist teams. There were no statistically significant differences in captopril use across age groups, with approximately 80% receiving it. Hydroxyzine use did not vary significantly by age, though its overall use was low. Hydroxyzine showed a non-significant trend towards greater blood pressure reduction compared to captopril. Captopril is the primary treatment for acute hypertension in emergency settings, but hydroxyzine may have potential benefits, especially in patients with anxiety-related hypertension. However, due to the lack of significant evidence and current guidelines advising against hydroxyzine in elderly patients, further research is needed to establish protocols and optimize hypertension treatment strategies. Additionally, incorporating anxiolytics into guidelines and an official statement on their use would aid clinical practice.

The authors have declared no competing interest.

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Komisja Bioetyczna przy UMK w Toruniu, Collegium Medicum w Bydgoszczy(The Bioethics Committee at Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz)

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