title: [Hypertensive crisis: urgency and hypertensive emergency].
abstract: Hypertensive crises lumped several clinical situations with different seriousness and prognosis. The differences between hypertensive urgency and hypertensive emergency depends on if this situation involves a vital risk for the patient. This risk is defined more by the severity of the organ damage than for the higher values of blood pressure. The hypertensive urgency not involves an immediately risk for the patient, for these reason, the treatment can be completed after discharged. Otherwise, the hypertensive emergency is a critical clinical condition that requires hospital assistance. Faced with a patient, with severe hypertension, asymptomatic or with unspecific symptoms we must be careful. First, we need to confirm the values of blood pressure, with several measures of blood pressure and investigate and treat factors, which triggered this situation. The objective of medical treatment for hypertensive urgency is to reduce blood pressure values (at least 20% of baseline values) but to avoid sudden reduction of these values. In hypertensive urgencies rapid acting drug should not be used because of the risk of ischemic stroke and use drugs with longer half-life. The cardiovascular risk of these patients is higher than that do not suffer hypertensive crisis. The treatment must be personalized in each hypertensive emergency and intravenous its the best route to treat these patients.
authors.affiliation: Unidad de Hipertensión, Fundación Hospital del Espíritu Santo, Universidad de Barcelona, Santa Coloma de Gramenet, España. Address: Unidad de hipertensión, Fundación Hospital del Espíritu Santo, Universidad de Barcelona, Avenida Mossen Pons i Rabada S/N, Santa Coloma de Gramenet, Barcelona, España. Email: jsobrino@hes.scs.es.
authors.forename: Javier
authors.initials: J
authors.lastname: Sobrino Martínez
authors.affiliation: Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna. Unidad de Riesgo Vascular, Nutrición y Envejecimiento IDIBAPS, Universidad de Barcelona, España.
authors.forename: Mónica
authors.initials: M
authors.lastname: Doménech Feria-Carot
authors.affiliation: Unidad de Imagen Cardiaca, Cardiocentro Ernesto Che Guevara, Villa Clara, Cuba.
authors.forename: Alberto
authors.initials: A
authors.lastname: Morales Salinas
authors.affiliation: Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna. Unidad de Riesgo Vascular, Nutrición y Envejecimiento IDIBAPS, Universidad de Barcelona, España.
authors.forename: Antonia
authors.initials: A
authors.lastname: Coca Payeras
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001794:Blood Pressure / Q000187:drug effects; D004630:Emergencies; D006207:Half-Life; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D057285:Precision Medicine; D011379:Prognosis; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents