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Hypertension crisis. Recognition and management.

T A Keith

    JAMA
    |April 11, 1977
    PubMed
    Summary

    Severe hypertension requires prompt treatment in specific critical conditions like aortic aneurysms or stroke. Parenteral antihypertensive drugs are used to rapidly lower blood pressure in these emergencies.

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    Area of Science:

    • Cardiology
    • Nephrology
    • Obstetrics

    Background:

    • Severe hypertension is uncommon but necessitates urgent intervention in specific clinical scenarios.
    • Certain medical emergencies are characterized by dangerously high blood pressure.

    Purpose of the Study:

    • To outline critical conditions requiring immediate systemic blood pressure reduction.
    • To identify effective parenteral antihypertensive agents for emergency use.

    Main Methods:

    • Review of clinical syndromes associated with severe hypertension.
    • Identification of parenteral drugs used for acute blood pressure lowering.
    • Consideration of adjunctive therapies like furosemide.

    Main Results:

    • Identified eight clinical syndromes necessitating vigorous antihypertensive therapy.
    • Listed key parenteral drugs including diazoxide, sodium nitroprusside, methyldopa, reserpine, and trimethaphan camsylate.
    • Noted that furosemide can potentiate the hypotensive effects of these agents.

    Conclusions:

    • Vigorous antihypertensive therapy is crucial for specific, infrequent, severe hypertension emergencies.
    • Parenteral agents offer rapid blood pressure reduction in life-threatening situations.
    • Clinical outcomes may vary despite theoretical advantages of these drugs.

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