Hypertensive emergencies

The clinical syndrome of accelerated hypertension is a relatively rare complication of hypertensive disease. The syndrome is recognized by high blood pressures, progressive neurologic and visual symptoms, acute renal damage, cardiac failure, and microangiopathic hemolytic anemia. When diagnosed, it must be recognized as an acute medical emergency. The patient should be admitted to an intensive care unit, arterial lines should be placed, and the blood pressure lowered as soon as possible. Once blood pressure has been controlled, oral medications should be begun. Long-term results in the treatment of hypertensive emergencies are gratifying. It is anticipated that with more experience gained in the use of medications in this situation, an even better prognosis will be achieved.