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[Hypertensive crisis: problems of diagnostics and paradigm of the treatment]

A N Fursov, N P Potekhin, S A Chernov

    Voenno-Meditsinskii Zhurnal
    |October 9, 2012
    PubMed

    Insights

    Hypertensive crisis is often overdiagnosed, with high blood pressure alone causing many cases. Introducing "catadrome of hypertensive disease" can improve diagnosis and hospital admission decisions.

    Area of Science:

    • Cardiology
    • Hypertension Research

    Context:

    • Analysis of a rise in uncomplicated hypertensive crisis (HC) from 46% to 61% reveals significant diagnostic challenges.
    • A substantial proportion of these cases are attributed solely to elevated arterial blood pressure (ABP) with minimal symptoms.

    Purpose:

    • To address the inappropriate classification of hypertensive disease catadrome as hypertensive crisis.
    • To propose the adoption of the term 'catadrome of hypertensive disease (instability of ABP)' alongside 'complicated' and 'uncomplicated' HC.
    • To optimize diagnostic accuracy and hospital admission indications.

    Summary:

    • The study identifies high arterial blood pressure (ABP) with minimal symptoms as a primary driver for the increase in uncomplicated hypertensive crisis diagnoses.
    • It argues against labeling all instances of hypertensive disease catadrome as hypertensive crisis.
    • The introduction of a distinct term, 'catadrome of hypertensive disease (instability of ABP),' is recommended to differentiate these conditions.

    Impact:

    • Implementing the proposed terminology can reduce the hyperdiagnosis of hypertensive crisis.
    • This distinction will lead to more appropriate indications for hospital admission.
    • Recommendations for medical management of complicated HC, uncomplicated HC, and catadrome of hypertensive disease are provided.

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