Hypertensive emergency

A hypertensive emergency is severe hypertensionwith acute impairment of an organ system(especially the central nervous system, cardiovascular systemand/or the renal system) and the possibility of irreversibleorgan-damage. In case of a hypertensive emergency, the blood pressureshould be lowered aggressively over minutes to hours with an antihypertensiveagent.

Several classes of antihypertensive agents are recommended and the choice for the antihypertensive agent depends on the cause for the hypertensive crisis, the severity of elevated blood pressure and the patients usual blood pressure before the hypertensive crisis. In most cases, the administration of an intravenoussodium nitroprussideinjectionwhich has an almost immediate antihypertensiveeffect is suitable but in many cases not readily available. In less urgent cases, oral agents like captopril, clonidine, labetalol, prazosin, which have all a delayed onset of action by several minutes compared to sodium nitroprusside, can also be used.

It is also important that the blood pressure is lowered not too abruptly, but smoothly. The diagnosis of a hypertensive emergency is not only based on the absolute level of blood pressure, but also on the individual regular regular level of blood pressure before the hypertensive crisis. Individuals with a history of chronichypertension may not tolerate a "normal" blood pressure.

Terminology

Generally, the terminology describing hypertensive emergencies can be confusing. Terms such as hypertensive crisis, malignant hypertension, hypertensive urgency, accelerated hypertensionand severe hypertensionare all used in the literature and often overlap.

Hypertensive emergency as a specific term

The term hypertensive emergency is primarily used as a specific term for a serious and urgent condition of elevated blood pressure (as described above) in contrast to hypertensive urgency for a less serious and less urgent condition of elevated blood pressure (the terminology hypertensive crisis is sometimes, although not quite often, also used in this sense).

Hypertensive emergency as a generic term

Sometimes, although not very often, the term hypertensive emergency is also used as a generic term, comprising both hypertensive emergency as a specific term for a serious and urgent condition of elevated blood pressure and hypertensive urgency as a specific term of a less serious and less urgent condition (the terminology hypertensive crisis is usually used in this sense).

See also

• Malignant hypertension
• Hypertension

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It uses material from the http://en.wikipedia.org/wiki/Hypertensive+emergency Wikipedia article Hypertensive emergency.