Management Strategies for Hypertensive Crisis: A Systematic Review

Area of Science:

• Cardiology
• Emergency Medicine
• Clinical Pharmacy

Background:

• A hypertensive crisis is a critical medical emergency characterized by a sudden, significant elevation in blood pressure (≥180/120 mmHg).
• It poses a severe risk for life-threatening complications, including myocardial infarction, stroke, and end-organ damage.
• Poor medication adherence and low follow-up rates contribute to high morbidity, mortality, and recurrence rates.

Purpose of the Study:

• To investigate and synthesize current management strategies for hypertensive crisis.
• To identify evidence-based approaches for controlling severe hypertension in acute settings.

Main Methods:

• A systematic review of English-language articles published between 2010 and 2024.
• Analysis of 15 selected articles focusing on hypertensive crisis diagnosis and management.
• Inclusion criteria specified investigative studies, data integrity, and management reports.

Main Results:

• Acute severe hypertension is linked to substantial mortality and morbidity, especially with end-organ damage.
• Current treatment protocols for hypertensive crisis vary significantly across hospital units and lack standardized, evidence-based guidance.
• Specific interventions like intravenous esmolol for aortic dissection and vasodilators (nitroglycerin, nitroprusside) are highlighted.

Conclusions:

• Effective management of hypertensive crisis requires tailored, evidence-based protocols, particularly in critical care settings.
• Standardization of blood pressure targets and treatment algorithms is crucial to mitigate risks associated with acute severe hypertension.
• Further research is needed to establish clear guidelines for managing hypertensive emergencies and improve patient adherence and follow-up.