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Dutch guideline for the management of hypertensive crisis -- 2010 revision

B J H van den Born1, J J Beutler, C A J M Gaillard

  • 1Department of Internal & Vascular Medicine, Academic Medical Centre, Amsterdam, the Netherlands. b.j.vandenborn@amc.uva.nl

The Netherlands Journal of Medicine
|June 8, 2011
PubMed

Insights

Hypertensive crises, including urgencies and emergencies, require updated management strategies. The 2010 Dutch guideline refines terminology and treatment for better patient outcomes in acute hypertensive disorders.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Hypertensive crises, encompassing urgencies and emergencies, are common acute hypertensive disorders.
  • Despite advances in hypertension treatment, complications and the need for renal replacement therapy persist.
  • The Netherlands introduced a guideline in 2003 for standardized, evidence-based hypertensive crisis management.

Purpose of the Study:

  • To provide an overview of current hypertensive crisis management.
  • To discuss significant changes in the 2010 revised Dutch guideline.
  • To update terminology and treatment recommendations for hypertensive emergencies and urgencies.

Main Methods:

  • Review of current management practices for hypertensive crisis.
  • Analysis of changes incorporated in the 2010 guideline revision.
  • Comparison of treatment options for hypertensive emergencies and urgencies.

Main Results:

  • Terminology updated: 'malignant hypertension' replaced by 'hypertensive crisis with retinopathy'.
  • Hypertensive crisis with retinopathy reclassified as an emergency.
  • Treatment shifts favor nicardipine for perioperative hypertension and labetalol for pre-eclampsia; oral nifedipine retard recommended for urgencies.

Conclusions:

  • The 2010 guideline refines hypertensive crisis classification and treatment, emphasizing specific drug choices for emergencies and urgencies.
  • New sections address management based on target organ involvement.
  • Public awareness and treatment of hypertension are crucial for reducing incidence and complications.

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