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ESC Council on hypertension position document on the management of hypertensive emergencies

Bert-Jan H van den Born1, Gregory Y H Lip2,3, Jana Brguljan-Hitij4

  • 1Department of Internal Medicine, Division of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.

European Heart Journal. Cardiovascular Pharmacotherapy
|August 31, 2018
PubMed

Insights

Hypertensive emergencies require immediate blood pressure reduction due to acute organ damage. Treatment depends on the specific organ affected, guiding drug choice, target BP, and reduction timeframe.

Area of Science:

  • Cardiology
  • Nephrology
  • Neurology

Background:

  • Hypertensive emergencies involve critically high blood pressure (BP) with acute end-organ damage.
  • Prompt, careful BP reduction is essential in these critical situations.

Purpose of the Study:

  • To define the critical factors determining management strategies for hypertensive emergencies.
  • To differentiate hypertensive emergencies from urgency based on organ damage.

Main Methods:

  • Clinical review of hypertensive emergencies and associated organ damage.
  • Analysis of factors influencing treatment decisions.

Main Results:

  • The specific type of acute organ damage dictates the choice of medication, target BP, and BP reduction timeline.
  • Key target organs include the heart, retina, brain, kidneys, and large arteries.
  • Absence of hypertension-mediated end-organ damage signifies a hypertensive urgency, manageable with oral agents.

Conclusions:

  • Management of hypertensive emergencies is organ-damage specific.
  • Accurate diagnosis of end-organ damage is crucial for appropriate and timely treatment.
  • Patients without end-organ damage do not require emergency intervention.

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