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Hypertensive emergencies.

C J Vaughan1, N Delanty

  • 1Department of Medicine, Weill Medical College of Cornell University, New York Presbyterian Hospital, NY, USA.

Lancet (London, England)
|September 6, 2000
PubMed
Summary
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Hypertensive emergencies involve uncontrolled high blood pressure damaging organs. Prompt treatment, often with parenteral medications, can reverse conditions like hypertensive posterior leucoencephalopathy syndrome.

Area of Science:

  • Cardiology
  • Nephrology
  • Neurology

Background:

  • Hypertensive emergency is uncontrolled hypertension with acute end-organ damage.
  • It often affects those with chronic hypertension but can occur in normotensive individuals, especially with pre-eclampsia or glomerulonephritis.
  • Pathophysiology involves complex mechanisms like renin-angiotensin-aldosterone system disturbances and inflammatory mediators.

Purpose of the Study:

  • To review the definition, pathophysiology, diagnosis, and management of hypertensive emergencies.
  • To highlight the importance of prompt treatment for reversible conditions like hypertensive posterior leucoencephalopathy syndrome.
  • To discuss current and novel therapeutic strategies.

Main Methods:

  • Literature review of pathophysiological mechanisms and clinical presentations.

Related Experiment Videos

  • Discussion of diagnostic findings, including MRI for hypertensive posterior leucoencephalopathy syndrome.
  • Analysis of therapeutic approaches, including parenteral agents and novel therapies.

    • Main Results:

    • Hypertensive emergencies can lead to acute end-organ damage.
    • Hypertensive posterior leucoencephalopathy syndrome, characterized by white matter edema, is a key finding and is potentially reversible.
    • Parenteral therapies like sodium nitroprusside, beta-blockers, labetalol, calcium-channel antagonists, and magnesium are commonly used.

    Conclusions:

    • Management is guided by specific end-organ complications.
    • Parenteral therapy is preferred, with various agents available.
    • Novel therapies targeting specific pathways are emerging.