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The management of hypertensive crises: a clinical review

M S Pergolini1

  • 1Department of Medical Clinics and Therapy, I Faculty of Medicine and Surgery, University Sapienza, Rome, Italy. mario.pergolini@uniroma1.it

La Clinica Terapeutica
|May 20, 2009
PubMed

Insights

Hypertensive crisis (HC) requires immediate management to prevent organ damage. Hypertensive emergencies need ICU care with IV drugs, while hypertensive urgencies can be treated with oral agents and close monitoring.

Area of Science:

  • Cardiology
  • Nephrology
  • Neurology

Background:

  • Hypertension is a common disorder in Western societies.
  • Hypertensive crisis (HC) affects less than 1% of patients due to improved chronic hypertension management.
  • Critical blood pressure elevation necessitates prompt management to prevent target organ injury.

Purpose of the Study:

  • To review current opinions on managing hypertensive crisis (HC).
  • To examine the most commonly used drugs for hypertensive crisis.
  • To differentiate therapeutic approaches for hypertensive emergencies (HE) and hypertensive urgencies (HU).

Main Methods:

  • Clinical review of current literature and expert opinions.
  • Analysis of therapeutic strategies for HE and HU.
  • Evaluation of drug classes used in managing HC.

Main Results:

  • Hypertensive emergencies (HE) require intensive care unit admission and parenteral antihypertensive drugs.
  • Hypertensive urgencies (HU) can be managed with oral agents and gradual blood pressure reduction over 12-48 hours.
  • Avoidance of drugs that lower blood pressure precipitously is crucial.

Conclusions:

  • Tailoring treatment for HC based on pathophysiology, clinical findings, mechanism of action, and side effects is essential.
  • Differentiated management strategies for HE and HU are critical for optimal patient outcomes.
  • Careful drug selection is paramount in managing hypertensive crisis to prevent adverse events.

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