Acute blood pressure elevation: Therapeutic approach

Area of Science:

• Cardiology
• Nephrology
• Internal Medicine

Background:

• International guidelines suggest avoiding the term "hypertensive crisis."
• Hypertensive emergencies and urgencies are distinct clinical presentations with different management approaches.
• Despite increased hypertension awareness, control, and treatment, hypertensive emergencies persist with high mortality.

Purpose of the Study:

• To provide an updated review of current data on the treatment of hypertensive emergencies.
• To clarify the diagnostic and therapeutic distinctions between hypertensive emergencies and urgencies.
• To highlight suboptimal adherence to international guidelines in managing hypertensive emergencies.

Main Methods:

• Literature review of recent studies on hypertensive emergencies.
• Analysis of international guidelines and clinical recommendations.
• Synthesis of data on diagnostic criteria and therapeutic interventions.

Main Results:

• Hypertensive emergencies are characterized by severely elevated blood pressure with evidence of acute target organ damage.
• Treatment of hypertensive emergencies requires prompt BP reduction to prevent further organ damage.
• Adherence to guideline-recommended treatment targets and drug choices in hypertensive emergencies is often suboptimal.

Conclusions:

• Accurate classification of severe hypertension into emergencies or urgencies is crucial for appropriate management.
• Effective treatment of hypertensive emergencies can mitigate mortality and morbidity.
• Further efforts are needed to improve adherence to evidence-based guidelines for hypertensive emergencies.