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Hypertensive Emergencies and Urgencies


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1 Ahmedabad, Gujarat, India
     

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Hypertensive Urgencies and Emergencies occur with severe elevations in BP. The presence of Target organ damage as a consequence of this raised BP differentiates Emergency from Urgency. While Hypertensive emergencies require admission and in some instances rapid control of BP, to prevent acute complications, Hypertensive urgencies can be managed on outpatient basis with slow reduction in BP. Clinical experience indicates that excessive reduction of BP may cause or contribute to renal, cerebral, or coronary ischemia and should be avoided. As autoregulation of tissue perfusion is disturbed in hypertensive emergencies, continuous infusion of short-acting titratable antihypertensive agents is preferred . Patients without chronic HT generally develop hypertensive crises at a lower BP than those with chronic HT. Situations like stroke and Eclampsia need specific considerations.
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  • Whelton PK, et al. 2017 High Blood Pressure Clinical Practice Guideline : Hypertension 2017;00:e000-e000
  • Systemic Hypertension : pg 399-409, Tintinalli’s Emergency Medicine : A comprehensive Study Guide : 8th Edition; 2016
  • Hypertension : Marx: Rosen’s Emergency medicine: Concepts and clinical practice: 6th edition
  • 2003 Seventh Report of the Joint National Committee: http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.htm.
  • Eighth Report of the Joint National Committee: 2013 Update

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  • Hypertensive Emergencies and Urgencies

Abstract Views: 280  |  PDF Views: 0

Authors

Sunil Thanvi
Ahmedabad, Gujarat, India

Abstract


Hypertensive Urgencies and Emergencies occur with severe elevations in BP. The presence of Target organ damage as a consequence of this raised BP differentiates Emergency from Urgency. While Hypertensive emergencies require admission and in some instances rapid control of BP, to prevent acute complications, Hypertensive urgencies can be managed on outpatient basis with slow reduction in BP. Clinical experience indicates that excessive reduction of BP may cause or contribute to renal, cerebral, or coronary ischemia and should be avoided. As autoregulation of tissue perfusion is disturbed in hypertensive emergencies, continuous infusion of short-acting titratable antihypertensive agents is preferred . Patients without chronic HT generally develop hypertensive crises at a lower BP than those with chronic HT. Situations like stroke and Eclampsia need specific considerations.

References