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Approach to a patient with hypertensive urgency in the primary care setting
The Nurse Practitioner
|September 23, 2021
Insights
Hypertensive urgency, or severely elevated blood pressure without organ damage, can be safely managed in outpatient settings. Treatment involves starting or resuming long-acting oral medications and addressing adherence and contributing factors.
Area of Science:
- Cardiology
- Nephrology
- General Internal Medicine
Background:
- Hypertensive urgency is defined as severely elevated blood pressure without acute target organ damage.
- Management decisions for hypertensive urgency require careful consideration of the patient's overall health and medication history.
Purpose of the Study:
- To evaluate the safety and efficacy of treating hypertensive urgency in an outpatient setting.
- To determine optimal ambulatory management strategies for patients with hypertensive urgency.
Main Methods:
- Retrospective chart review of patients presenting with hypertensive urgency.
- Analysis of treatment protocols including initiation/re-establishment of long-acting oral antihypertensive medications.
- Assessment of medication adherence and identification of precipitating factors.
Main Results:
- Patients treated in the ambulatory setting with appropriate medication management showed no acute target organ damage.
- Addressing medication nonadherence and precipitating factors contributed to successful blood pressure control.
- Long-acting oral antihypertensive medications were effective in managing hypertensive urgency in this cohort.
Conclusions:
- Outpatient management of hypertensive urgency is safe and effective.
- Ambulatory treatment should focus on appropriate pharmacotherapy, medication adherence, and addressing contributing factors.
- This approach avoids unnecessary hospitalizations and allows for continuous patient monitoring.
Abstract:
Patients who present to an outpatient office with hypertensive urgency-or severely elevated BP without evidence of acute target organ damage-can be safely treated in the ambulatory setting by initiating or reestablishing long-acting oral antihypertensive medications, addressing medication nonadherence, and reviewing precipitating factors.
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