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Hypertensive Urgency and Emergency in Alcohol Withdrawal: A Literature Review

Ermal Bojdani1,2,3,4, Anderson Chen2,3,4, Tina Zhang5

  • 1Harvard South Shore Psychiatry Residency Training Program, 940 Belmont St, Brockton, MA 02301. Bojdani2@gmail.com.

The Primary Care Companion for CNS Disorders
|December 18, 2019
PubMed

Insights

Hypertension can occur during alcohol detoxification, potentially leading to hypertensive urgency or emergency. Clinicians should monitor blood pressure and individualize treatment, considering patient comorbidities and potential end-organ damage.

Area of Science:

  • Internal Medicine
  • Cardiology
  • Addiction Medicine

Background:

  • Alcohol withdrawal syndrome (AWS) can manifest with significant physiological changes.
  • Hypertension is a common, though often transient, finding during AWS.
  • The risk of hypertensive urgency and emergency in AWS patients necessitates clinical vigilance.

Purpose of the Study:

  • To inform clinicians about the potential for hypertension, hypertensive urgency, and hypertensive emergency in patients undergoing alcohol detoxification.
  • To review diagnostic and treatment strategies for managing blood pressure in this specific patient population.

Main Methods:

  • A comprehensive literature search was conducted on PubMed using terms related to alcohol withdrawal and hypertension.
  • Studies were screened for relevance, with a focus on recent publications, and supplemented by expert-reviewed articles.
  • Searches for specific terms related to hypertensive urgency/emergency and treatment-resistant hypertension in AWS yielded limited results.

Main Results:

  • Hypertension during AWS is generally self-limiting but requires management to prevent severe complications.
  • Limited data exists on optimal hypertension management in AWS patients, often requiring individualized approaches.
  • Patients with pre-existing treatment-resistant hypertension may experience more challenging blood pressure control during withdrawal.

Conclusions:

  • Treatment for hypertension in AWS involves selecting medications based on side effect profiles and patient comorbidities.
  • Patients with suspected hypertensive urgency or emergency require thorough medical evaluation to assess for end-organ damage.
Abstract

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