Clinical Features and Management of Selected Hypertensive Emergencies
Open Access
- 1 October 2004
- journal article
- review article
- Published by Wiley in The Journal of Clinical Hypertension
- Vol. 6 (10), 587-592
- https://doi.org/10.1111/j.1524-6175.2004.03608.x
Abstract
A hypertensive emergency, defined as an elevated blood pressure with evidence of acute target organ damage, can manifest in many forms, including neurological, cardiac, renal, and obstetric. After diagnosis, effective parenteral antihypertensive therapy (typically, nitroprusside starting at 0.5 μg/kg/min, but some physicians prefer fenoldopam or nicardipine) should be given in the hospital. In general, blood pressure should be reduced about 10% during the first hour and another 15% gradually over 2–3 more hours. The exception is aortic dissection, for which treatment includes a β blocker, and the target is systolic blood pressure <120 mm Hg after 20 minutes. Oral antihypertensive therapy can usually be instituted after 6–12 hours of parenteral therapy. Consideration should be given to secondary causes of hypertension after transfer from the intensive care unit. Because of advances in antihypertensive therapy and management, “malignant hypertension” should be malignant no longer.Keywords
This publication has 12 references indexed in Scilit:
- Management of hypertension emergenciesCurrent Hypertension Reports, 2003
- Aortic Dissection: New Frontiers in Diagnosis and ManagementCirculation, 2003
- Fenoldopam — A Selective Peripheral Dopamine-Receptor Agonist for the Treatment of Severe HypertensionNew England Journal of Medicine, 2001
- Management of hypertensive crises: the scientific basis for treatment decisionsAmerican Journal of Hypertension, 2001
- Reversal of Catabolism by Beta-Blockade after Severe BurnsNew England Journal of Medicine, 2001
- Calcium channel blockers in the management of preterm labor and hypertension in pregnancyEuropean Journal of Obstetrics & Gynecology and Reproductive Biology, 2001
- HYPERTENSIVE EMERGENCIESCritical Care Clinics, 2001
- Treatment of Acute Ischemic StrokeNew England Journal of Medicine, 2000
- Comparative Tolerability Profile of Hypertensive Crisis TreatmentsDrug Safety, 1998
- Should a moratorium be placed on sublingual nifedipine capsules given for hypertensive emergencies and pseudoemergencies?Published by American Medical Association (AMA) ,1996