Current diagnosis and management of hypertensive emergency.
The appropriate and timely evaluation and treatment of patients with severely elevated blood pressure is essential to avoid serious adverse outcomes. Most importantly, the distinction between a hypertensive emergency (crisis) and urgency needs to be made. A sudden elevation in systolic (SBP) and/or diastolic blood pressure (DBP) that is associated with acute end organ damage (cardiovascular, cerebrovascular, or renal) is defined as a hypertensive crisis or emergency. In contrast, acute elevation in SBP and/or DBP not associated with evidence of end organ damage is defined as hypertensive urgency. In patients with a hypertensive emergency, blood pressure control should be attained as expeditiously as possible with parenteral medications to prevent ongoing and potentially permanent end organ damage. In contrast, with hypertensive urgency, blood pressure control can be achieved with the use of oral medications within 24-48 hours. This paper reviews the management of hypertensive emergencies.
Haas
Andrew R
AR
Division of Critical Care, Pulmonary, Allergy and Immunologic Disease, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Marik
Paul E
PE
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000784:Aortic Dissection / Q000188:drug therapy / Q000209:etiology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001014:Aortic Aneurysm / Q000188:drug therapy / Q000209:etiology; D001794:Blood Pressure / Q000187:drug effects; D004638:Emergency Treatment / Q000639:trends*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis / Q000188:drug therapy; D011247:Pregnancy; D011725:Pyridines / Q000627:therapeutic use; D020521:Stroke / Q000188:drug therapy / Q000209:etiology; D014665:Vasodilator Agents / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D011725:Pyridines; D014665:Vasodilator Agents; C118563:clevidipine