Therapeutic Approach to Hypertension Urgencies and Emergencies in the Emergency Room

High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension
Alessandro MalobertiCristina Giannattasio

Abstract

Hypertensive urgencies-emergencies are important and common events. They are defined as a severe elevation in BP, higher than 180/120 mmHg, associated or not with the evidence of new or worsening organ damage for emergencies and urgencies respectively. Anamnestic information, physical examination and instrumental evaluation determine the following management that could need oral (for urgencies) or intravenous (for emergencies) anti-hypertensives drugs. The choice of the specific drugs depend on the underlying causes of the crisis, patient's demographics, cardiovascular risk and comorbidities. For emergencies a maximum BP reduction of 20-25% within the first hour and then to 160/110-100 over next 2-6 h, is considered appropriate with a further gradual decrease over the next 24-48 h to reach normal BP levels. In the case of hypertensive urgencies, a gradual lowering of BP over 24-48 h with an oral medication is the best approach and an aggressive BP lowering should be avoided. Subsequent management with particular attention on chronic BP values control is important as the right treatment of the acute phase.

References

May 1, 1988·Journal of the American College of Cardiology·W B WhiteA M Katz
Jan 1, 1983·Journal of Cardiovascular Pharmacology·T PaschG Hoppelshäuser
Dec 1, 1980·Clinical Pharmacology and Therapeutics·T M LuddenM S Lin
Sep 1, 1993·Clinical Pharmacology and Therapeutics·R DonnellyH L Elliott
Jan 1, 1996·Hypertension·B ZampaglioneP Cavallo-Perin
Apr 26, 1996·Biochemical Pharmacology·H Niknahad, P J O'Brien
Apr 1, 1997·Journal of Cardiothoracic and Vascular Anesthesia·J L VincentR J Khan
Aug 1, 1997·Journal of Human Hypertension·A DamascenoJ Polónia
Aug 15, 1998·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·E GrossmanF H Messerli
Nov 30, 1999·The International Journal of Angiology : Official Publication of the International College of Angiology, Inc·K GemiciJ Cordan
Mar 10, 2001·The American Journal of Emergency Medicine·J Alijotas-ReigR Angles-Coll
Jan 17, 2002·The New England Journal of Medicine·M B MurphyG D Shorten
May 2, 2003·The New England Journal of Medicine·Umesh N KhotGary S Francis
Aug 24, 2004·Arquivos brasileiros de cardiologia·José Fernando Vilela MartinJosé Paulo Cipullo
Jun 15, 2007·Chest·Paul E Marik, Joseph Varon
Jul 9, 2009·The Annals of Pharmacotherapy·Kenneth W Kenyon
Jul 29, 2009·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Denise Rhoney, W Frank Peacock
May 12, 2010·Circulation·Lynda A SzczechUNKNOWN Studying the Treatment of Acute Hypertension Investigators
Nov 18, 2011·Critical Care : the Official Journal of the Critical Care Forum·Alain VuylstekeUNKNOWN Euro-STAT Investigators
Feb 2, 2012·The American Journal of Cardiology·Apurva BadhekaLuis Afonso
May 27, 2014·The American Journal of Emergency Medicine·Serafin FariasPhillip D Levy
Jan 13, 2015·Journal of Cardiovascular Medicine·Maria Lorenza MuiesanUNKNOWN Working Group on Hypertension, Prevention, Rehabilitation of the Italian Society of Cardiology, the Societa’ Italiana dell’I
Jun 20, 2015·The American Journal of Emergency Medicine·Phillip D LevyRobert D Welch
Sep 28, 2015·The Journal of Emergency Medicine·Adnan KayaAhmet Murat
Apr 1, 1979·British Journal of Clinical Pharmacology·P G Marx, D S Reid
Jun 14, 2016·JAMA Internal Medicine·Krishna K PatelMichael B Rothberg

❮ Previous
Next ❯

Citations

Jul 1, 2020·Journal of Clinical Pharmacology·Pattraporn Chera-AreeTuangsit Wataganara
Feb 6, 2021·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Maria Lorenza MuiesanUNKNOWN Italian Society of Hypertension
Oct 28, 2021·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Rami Z MorsiAiden Abidov
Nov 24, 2021·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Gian Paolo RossiTeresa M Seccia

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.