Related Experiment Video
Updated: Apr 18, 2026

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
An update on hypertensive emergencies and urgencies
Maria Lorenza Muiesan1, Massimo Salvetti, Valentina Amadoro
1aDepartment of Clinical and Experimental Sciences University of Brescia, 25100 Spedali Civili, Brescia bDepartment of Medical-Surgery Sciences and Translational Medicine, Emergency Department, University La Sapienza, Sant'Andrea Hospital Rome, Rome cDepartment of Internal Medicine and Therapeutics, University of Pavia, Lombardy dDepartment of Internal Medicine 1, USL12 Veneziana, Venice eDepartment of Medicine, University of Padua, Padova fDepartment of ScienzeMediche e Chirurgiche, S.Orsola-Malpighi University Hospital, Bologna gDivision of Cardiology, Department of Medicina Clinica e Molecolare, University Roma 'Sapienza' - Azienda Ospedaliera Sant'Andrea, and IRCCS Neuromed, Rome hDivision of Cardiology, AOU Sassari, Sassari iDepartment of Cardiovascular Diseases, University of Siena, Tuscany jCardiovascular Disease Section, Department of Emergency and Organ Tranplantation, University of Bari, Bari kAS Department of Cardiology, Brindisi District, Brindisi lDepartment of Clinical and Experimental Medicine, University of Florence, Florence mDepartment of Internal Medicine and Cardiovascular Diseases, University of Palermo, Palermo nDipartimento di Patologia Chirurgica, Medica, Molecolare e dell'Area Critica, Università di Pisa, Pisa, Italy.
Hypertensive emergencies and urgencies require distinct management strategies despite evolving demographics. Current treatments are often inappropriate, highlighting the need for updated approaches to reduce morbidity and mortality.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- Severe acute arterial hypertension, commonly termed hypertensive crisis, encompasses distinct conditions: hypertensive emergencies and hypertensive urgencies.
- These conditions, despite changes in prevalence and demographics over four decades, remain significant contributors to morbidity and mortality.
- Existing guidelines from major societies exist, yet clinical practice often deviates, leading to suboptimal patient outcomes.
Purpose of the Study:
- To review and clarify the diagnostic and therapeutic approaches for hypertensive emergencies and urgencies.
- To highlight the discrepancies between current guidelines and clinical practice in managing severe hypertension.
- To provide an updated perspective on the management and treatment of hypertensive emergencies and urgencies based on recent data.
Main Methods:
- Literature review of recent data and guidelines from the Joint National Committee and the European Society of Hypertension.
- Analysis of the changing prevalence and demographics of hypertensive emergencies and urgencies.
- Comparative assessment of recommended versus actual treatment protocols.
Main Results:
- Hypertensive emergencies and urgencies possess fundamentally different diagnostic criteria and therapeutic interventions.
- Despite updated guidelines, inappropriate treatment of these severe hypertension states persists.
- The review underscores the critical need for adherence to evidence-based management strategies.
Conclusions:
- Accurate differentiation between hypertensive emergencies and urgencies is crucial for appropriate patient care.
- Current therapeutic practices for severe hypertension require significant improvement to align with established guidelines.
- Implementing evidence-based management is essential to mitigate the significant morbidity and mortality associated with these conditions.
Related Concept Videos
Hypertension I: Introduction
Introduction Cardiac Emergencies
Hypertension III: Clinical Manifestations and Diagnostic Studies
Blood Pressure Imbalances and Circulatory Shock
Blood Pressure: Hypertension and Hypotension
Normal blood pressure is 120/80 mm Hg. Elevated blood pressure is 120-129/under 80 mm Hg. Hypertension, warranting treatment at 130/80 mm Hg, is often asymptomatic and can lead to severe cardiovascular events, aneurysms, peripheral arterial disease, chronic renal disease, or cardiac...
Hypertension and Regulation of Blood Pressure
Hypertension V: Nursing Management

