[Rational treatment of hypertensive crises].
The Hypertensive Crisis can be divided into Emergencies and Urgencies. Hypertension may be unknown at presentation. The Emergencies have acute or ongoing end-organ damage (neurological, renal or cardiovascular). It is crucial to recognize one from another already at the emergency room evaluation. There is no arbitrary level of blood pressure separating hypertensive emergencies and urgencies. Ideally, this patients must be treated in an intensive care unit. The level to which the blood pressure should be lowered and the election of the treatment, parenteral versus oral, depends on the patient's general condition and should be individualized. The general recommendation is to reduce the mean arterial pressure gradually in the first 48 hours by no more than 20 percent or to a diastolic blood pressure not lower than 100 mmHg. A relatively asymptomatic patient, even with high diastolic lectures does not need to be treated with parenteral drugs. The patient should be evaluated for possible factors that may have contributed to the high of blood pressure and the progression of hypertension.
Juárez Herrera
Ursulo
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Departamento de Urgencias y Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez, INCICH, Juan Badiano No. 1, Col. Sección XVI, Tlalpan, 14080 México, D. F. ujuarez@mail.medinet.net.mx
D004630:Emergencies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology / Q000628:therapy*