[Hypertensive crisis and its treatment]

Sudden and large increase of the blood pressure may be life-threatening, particularly when they are accompanied by encephalopathy, left-ventricular insufficiency or other complications. The crisis of hypertension shall be treated possibly without loss of time and with energy. If there is the possibility for a permanent control of the patient, the infusion by drops of nitroprusside sodium is the therapy of choice. It at once decreases the blood pressure and is free of side-effects. Diazoxide has the advantage compared with nitroprusside sodium that an intravenous injection decreases the blood pressure for several hours. But the rapid and drastic decrease of blood pressure may occasionally be dangerous in patients with coronary insufficiency and cerebral arteriosclerosis. In certain indications also other medicaments, such as reserpine, alpha-methyldopa, phentolamine, saralasin or nifedipine can be applied. The crisis of hypertension is always to be regarded as an emergency situation, since always irreversible lesions may be appear on the different organs as a sequel of the permanent vasoconstriction and ischaemia.