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Hypertensive urgencies and emergencies
1Section of Hospital Medicine, Division of General Internal Medicine, Wayne State University, Detroit, Michigan 48201, USA. tshafi@med.wayne.edu
Abstract:
Severely elevated blood pressure (BP) is commonly encountered in acute care settings. Initial evaluation of patients with severe hypertension should focus on determining the presence and extent of acute target organ damage. Hypertensive emergencies are life-threatening conditions that require immediate reduction of BP in an intensive care unit. Hypertensive urgencies-and severe uncontrolled hypertension also require prompt attention with gradual lowering of BP. There are a number of drugs available for the treatment of these disorders. Careful reduction in BP with special attention to cerebral circulation is key to managing these patients.
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Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.