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3.1.7 - Management of Hypertensive Crises

from Section 3.1 - Cardiac and Circulatory Failure

Published online by Cambridge University Press:  27 July 2023

By
Katarina Lenartova  and
Anne-Marie Leo
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. These patients can present with vague symptoms or no symptoms at all.

  2. 2. It is important to establish if there is end-organ damage at an earlier stage in the course of treatment.

  3. 3. Distinguishing a hypertensive emergency from hypertensive urgencies helps in guiding acute treatment.

  4. 4. Aim to reduce the systolic blood pressure within the first hour according to the appropriate recommended level for the condition involved.

  5. 5. The choice of pharmacological agent and target blood pressure should be determined by the underlying pathology.

Keywords

hypertensive emergencieshypertensive urgenciesend-organ damagemedications
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 117 - 121
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Babar, TB, Basman, CL. Hypertension. In: Ferri, FF (ed). Ferri’s Clinical Advisor 2017. E-Book. Philadelphia, PA: Elsevier; 2017. pp. 639–643.e4.Google Scholar
Pinna, G, Pascale, C, Fornengo, P, et al. Hospital admissions for hypertensive crisis in emergency departments: a large multicenter Italian study. PLoS One 2014;9:393542.CrossRefGoogle ScholarPubMed
Shayne, P, Lynch, CA. Hypertensive crisis. In: Adams, JG, Barton, ED, Collings, JL, DeBlieux, PMC, Gisondi, MA, Nadel, ES (eds). Emergency Medicine E-Book Clinical Essentials, 2nd edn. Philadelphia, PA: Saunders; 2013. pp. 592–601.e1.Google Scholar
Suneja, M, Sanders, L. Hypertensive emergency. Med Clin North Am 2017;101:465–78.CrossRefGoogle ScholarPubMed
Whelton, PK, Carey, RM, Aornow, WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018;71:e13–115.Google Scholar

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