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Hypertensive crises

Christopher J Hebert1, Donald G Vidt

  • 1Department of Nephrology and Hypertension, Cleveland Clinic, Suite A51, 9500 Euclid Avenue, Cleveland, OH 44195, USA. hebertc@ccf.org

Primary Care
|August 20, 2008
PubMed

Insights

Hypertensive crises, marked by very high blood pressure and organ damage, are preventable. Proper patient triage and management, distinguishing between urgency and emergency, are crucial for effective treatment and follow-up.

Area of Science:

  • Cardiology
  • Nephrology
  • Emergency Medicine

Background:

  • Hypertensive crises are medical emergencies defined by severely elevated blood pressure with acute target organ damage.
  • Many elevated blood pressure readings in clinical settings do not represent a crisis and do not necessitate immediate reduction.

Purpose of the Study:

  • To differentiate between severe hypertension, hypertensive urgency, and hypertensive emergency.
  • To guide appropriate therapeutic strategies based on patient classification.
  • To emphasize the importance of preventing and managing hypertensive crises.

Main Methods:

  • Clinical assessment including history, physical examination, and laboratory testing.
  • Triage of patients into distinct categories of hypertensive conditions.
  • Review of management protocols for hypertensive urgency and emergency.

Main Results:

  • Most elevated blood pressure readings in office settings are not hypertensive crises.
  • Hypertensive crises are often linked to poor hypertension management or non-adherence to treatment.
  • Hypertensive urgency is typically managed outpatient with oral medications.
  • Hypertensive emergencies require intensive care unit admission and intravenous therapy.

Conclusions:

  • Effective triage is essential for appropriate management of severe hypertension.
  • Preventive strategies and adherence to therapy can reduce the incidence of hypertensive crises.
  • Close follow-up is critical after managing elevated blood pressure to prevent recurrence or complications.

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