Document Detail


Evaluation and treatment of severe asymptomatic hypertension.
MedLine Citation:
PMID:  20148501     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Poorly controlled hypertension is a common finding in the outpatient setting. When patients present with severely elevated blood pressure (i.e., systolic blood pressure of 180 mm Hg or greater, or diastolic blood pressure of 110 mm Hg or greater), physicians need to differentiate hypertensive emergency from severely elevated blood pressure without signs or symptoms of end-organ damage (severe asymptomatic hypertension). Most patients who are asymptomatic but have poorly controlled hypertension do not have acute end-organ damage and, therefore, do not require immediate workup or treatment (within 24 hours). However, physicians should confirm blood pressure readings and appropriately classify the hypertensive state. A cardiovascular risk profile is important in guiding the treatment of severe asymptomatic hypertension; higher risk patients may benefit from more urgent and aggressive evaluation and treatment. Oral agents may be initiated before discharge, but intravenous medications and fast-acting oral agents should be reserved for true hypertensive emergencies. High blood pressure should be treated gradually. Appropriate, repeated follow-up over weeks to months is needed to reach desired blood pressure goals.
Authors:
Chad S Kessler; Yazen Joudeh
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American family physician     Volume:  81     ISSN:  1532-0650     ISO Abbreviation:  Am Fam Physician     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-12     Completed Date:  2010-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1272646     Medline TA:  Am Fam Physician     Country:  United States    
Other Details:
Languages:  eng     Pagination:  470-6     Citation Subset:  AIM; IM    
Affiliation:
University of Illinois at Chicago College of Medicine, Chicago, IL, USA. chad.kessler@va.gov
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / administration & dosage*
Humans
Hypertension / diagnosis*,  drug therapy*,  physiopathology
Risk Factors
Severity of Illness Index
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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