Hypertensive crises.
The key points of this article are: (1) A hypertensive crisis is present when markedly elevated blood pressure is accompanied by progressive or impending acute target organ damage. (2) Most instances of very elevated blood pressure encountered in the office setting will not be crises and will not require acute reduction of blood pressure. (3) Hypertensive crises are largely preventable and often result from inadequate management of hypertension or poor adherence to therapy. (4) Effective triage of patients into categories of severe hypertension, hypertensive urgency, and hypertensive emergency through an expeditious history, examination, and testing should guide therapy. (5) Hypertensive urgency is managed with oral medications and usually on an outpatient basis; a hypertensive emergency warrants intensive care unit admission and parenteral therapy. (6) Ensuring adequate follow-up after treatment of very elevated blood pressure is a critical step that is often mishandled.
Hebert
Christopher J
CJ
Department of Nephrology and Hypertension, Cleveland Clinic, Suite A51, 9500 Euclid Avenue, Cleveland, OH 44195, USA. hebertc@ccf.org
Vidt
Donald G
DG
D000553:Ambulatory Care / Q000379:methods*; D000784:Aortic Dissection / Q000209:etiology / Q000628:therapy; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001014:Aortic Aneurysm / Q000209:etiology / Q000628:therapy; D019091:Critical Pathways; D004638:Emergency Treatment / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006974:Hypertension, Malignant / Q000175:diagnosis / Q000188:drug therapy; D046110:Hypertension, Pregnancy-Induced / Q000628:therapy; D010343:Patient Admission / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods*; D011654:Pulmonary Edema / Q000209:etiology / Q000628:therapy; D020521:Stroke / Q000209:etiology / Q000628:therapy; D014481:United States / Q000453:epidemiology
D000959:Antihypertensive Agents