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Catecholamine-induced hypertensive crises: current insights and management
Matthew A Nazari1, Rockyb Hasan1, Mark Haigney2
1Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
The Lancet. Diabetes & Endocrinology
|November 9, 2023
Summary
Catecholamine-induced hypertensive crises from phaeochromocytomas and paragangliomas are treatable. Early diagnosis and flexible treatment strategies can mitigate severe complications and improve patient outcomes.
Area of Science:
- Endocrinology
- Cardiology
- Oncology
Background:
- Phaeochromocytomas and paragangliomas (PPGLs) cause catecholamine-induced hypertensive (CIH) crises.
- CIH crises present diagnostic challenges and lack defined treatment protocols, often needing multidisciplinary care.
Purpose of the Study:
- To provide evidence-based guidance for diagnosing and managing CIH crises.
- To outline flexible treatment approaches considering drug availability and provider preference.
Main Methods:
- Review of existing evidence and 60 years of clinical experience.
- Analysis of data from over 2600 PPGL patients and 100 NIH patients with CIH crises.
Main Results:
- CIH crises can lead to severe complications like tachyarrhythmias and target organ damage.
- Biochemical diagnosis can be difficult due to confounding factors.
- Available medications can effectively manage CIH crises and their complications.
Conclusions:
- Effective intervention for CIH crises is achievable with available drugs.
- Flexible, customized treatment strategies can mitigate morbidity and mortality in patients with PPGL-related CIH crises.
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