Document Detail


Hypertensive crisis.
MedLine Citation:
PMID:  20160537     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Hypertension is a common chronic medical condition affecting over 65 million Americans. Uncontrolled hypertension can progress to a hypertensive crisis defined as a systolic blood pressure >180 mm Hg or a diastolic blood pressure >120 mm Hg. Hypertensive crisis can be further classified as a hypertensive urgency or hypertensive emergency depending on end-organ involvement including cardiac, renal, and neurologic injury. The prompt recognition of a hypertensive emergency with the appropriate diagnostic tests and triage will lead to the adequate reduction of blood pressure, ameliorating the incidence of fatal outcomes. Severely hypertensive patients with acute end-organ damage (hypertensive emergencies) warrant admission to an intensive care unit for immediate reduction of blood pressure with a short-acting titratable intravenous antihypertensive medication. Hypertensive urgencies (severe hypertension with no or minimal end-organ damage) may in general be treated with oral antihypertensives as an outpatient. Rapid and short-lived intravenous medications commonly used are labetalol, esmolol, fenoldopam, nicardipine, sodium nitroprusside, and clevidipine. Medications such as hydralazine, immediate release nifedipine, and nitroglycerin should be avoided. Sodium nitroprusside should be used with caution because of its toxicity. The risk factors and prognosticators of a hypertensive crisis are still under recognized. Physicians should perform complete evaluations in patients who present with a hypertensive crisis to effectively reverse, intervene, and correct the underlying trigger, as well as improve long-term outcomes after the episode.
Authors:
Maria Alexandra Rodriguez; Siva K Kumar; Matthew De Caro
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cardiology in review     Volume:  18     ISSN:  1538-4683     ISO Abbreviation:  Cardiol Rev     Publication Date:    2010 Mar-Apr
Date Detail:
Created Date:  2010-02-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9304686     Medline TA:  Cardiol Rev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  102-7     Citation Subset:  IM    
Affiliation:
Department of Medicine, Cardiology Division, Jefferson Medical College/Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA. maria.a.rodriguez@jeffersonhospital.org
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