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Hypertensive Crisis

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Abstract

Understand the difference between malignant hypertension, hypertensive emergency, and hypertensive urgency. Understand the pathophysiology of a hypertensive crisis. Evaluate and diagnose hypertensive crisis using history, physical examination, and laboratory studies. Know the various classes of drugs to treat hypertensive crisis, their mechanisms of action, and their use in treating hypertensive emergencies. Recognize the secondary causes of hypertensive emergencies and the drugs used in their treatment.

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References

  1. Hajjar I, Kotchen JM, Kotchen TA. Hypertentsion: trends in prevalence, incidence, and control. Ann Rev Public Health. 2006;27: 465-490.

    Article  Google Scholar 

  2. Cutler JA, Sorlie PD, Wolz M, Fields LE, Roccella EJ. Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988-1994 and 1999-2004. Hypertension. 2008;52:818-827.

    Article  PubMed  CAS  Google Scholar 

  3. Chobanian AV, Bakris GL, Black HR, Cushman WC. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289:2560-2572.

    Article  PubMed  CAS  Google Scholar 

  4. Bennett NM, Shea S. Hypertensive emergency: case criteria sociodemographic profile, and previous care of 100 cases. Am J Public Health. 1988;78:636-640.

    Article  PubMed  CAS  Google Scholar 

  5. Anon. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med. 1993;153:154-183.

    Article  Google Scholar 

  6. Gudbrandsson T. Malignant hypertension: a clinical follow-up study with special reference to renal and cardiovascular function and immunogenetic factors. Acta Med Scand. 1981;suppl 650:1-62.

    CAS  Google Scholar 

  7. Zampaglione B, Pascale C, Marchisio M, et al. Hypertentive urgencies and emergencies: prevalence and clinical presentation. Hypertension. 1998;27:144-147.

    Article  Google Scholar 

  8. Aggarwal M, Khan IA. Hypertensive crisis: hypertensive emergencies and urgencies. Cardiol Clin. 2006;24:135-146.

    Article  PubMed  Google Scholar 

  9. Potter JF. Malignant hypertension in the elderly. Q J Med. 1995; 86:641-647.

    Google Scholar 

  10. Tisdale JE, Huang MB, Borzak S, et al. Risk factors for hypertensive crisis: importance of out-patient blood pressure control. Fam Pract. 2004;21:420-424.

    Article  PubMed  Google Scholar 

  11. Webster J, Petrie JC, Jeffers TA, et al. Accelerated hypertension patterns of mortality and clinical factors affecting outcome in treated patients. Q J Med. 1993;96:485-493.

    Article  Google Scholar 

  12. Kitiyakara C, Guzman NJ. Malignant hypertension and hypertensive emergencies. J Am Soc Nephrol. 1998;9:133-142.

    PubMed  CAS  Google Scholar 

  13. Linfors EW, Feussner JR, Blessing CL, et al. Spurious hypertension in the obese patient: effect of sphyganomanometer cuff size on prevalence of hypertension. Arch Intern Med. 1984;144:1482-1485.

    Article  PubMed  CAS  Google Scholar 

  14. Strandgaard S, Olesen J, Skinhoj E, et al. Autoregulation of brain circulation in severe arterial hypertension. BMJ. 1973;1:507-510.

    Article  PubMed  CAS  Google Scholar 

  15. Vaughan CJ, Delanty N. Hypertensive emergencies. Lancet. 2000; 356:411-417.

    Article  PubMed  CAS  Google Scholar 

  16. Khan IA, Nair CK. Clinical, diagnostic, and management perspectives of aortic dissection. Chest. 2002;122:311-328.

    Article  PubMed  Google Scholar 

  17. Estera AL, Miller CC III, Safi HJ, et al. Outcomes of medical management of acute type B aortic dissection. Circulation. 2006;114:1384-1389.

    Google Scholar 

  18. Marik PE, Varon J. Hypertensive crisis: challenges and management. Chest. 2007;131:1949-1962.

    Article  PubMed  CAS  Google Scholar 

  19. Hebert CJ, Vidt DG. Hypertensive crisis. Prim Care Clin Office Pract. 2008;35:475-487.

    Article  Google Scholar 

  20. Friederich JA, Butterworth JF. Sodium nitroprusside twenty years and counting. Anes Analg. 1995;81:152-162.

    CAS  Google Scholar 

  21. Mann T, Cohn PF, Holman LB, et al. Effect of nitroprusside on regional myocardial blood flow in coronary artery disease: results in 25 patients and comparison with nitroglycerin. Circulation. 1978;57:732-738.

    Article  PubMed  CAS  Google Scholar 

  22. Cohn JN, Franciosa JA, Francis GS, et al. Effect of short-term infusion of sodium nitoprusside on mortality rate in acute myocardial infarction complicated by left ventricular failure: results of a Veterens Administration cooperative study. N Engl J Med. 1982;306:1129-1135.

    Article  PubMed  CAS  Google Scholar 

  23. Anile C, Zanghi F, Bracli A, et al. Sodium nitroprusside and intracranial pressure. Acta Neurochir. 1981;58:203-211.

    Article  PubMed  CAS  Google Scholar 

  24. Robin ED, McCauley R. Nitroprusside-related cyanide poisoning. Chest. 1992;102:1842-1845.

    Article  PubMed  CAS  Google Scholar 

  25. Shepherd AM, Ludden TM, McNay JL, et al. Hydralazine kinetics after single and repeated oral doses. Clin Pharmacol Ther. 1980; 28:804-811.

    Article  PubMed  CAS  Google Scholar 

  26. Ludden TM, Shepherd AM, McNay JL, et al. Hydralazine kinetics in hypertensive patients after intravenous administration. Clin Pharmacol Ther. 1980;28:736-742.

    Article  PubMed  CAS  Google Scholar 

  27. Lund-Johansen P. Pharmacology of combined alpha-beta-blockade II. Hemodynamic effects of labetalol. Drugs. 1984;28(suppl 2): 35-50.

    Article  PubMed  Google Scholar 

  28. Shusterman NH, Elliott WJ, White WB. Fenoldopam, but not nitroprusside, improves renal function in severely hypertensive patients with impaired renal function. Am J Med. 1993;95:161-168.

    Article  PubMed  CAS  Google Scholar 

  29. Rodriguez G, Varon J. Clevidipine; a unique agent for the critical care practitioner. Crit Care Shock. 2006;9:9-15.

    Google Scholar 

  30. Adams HP, Adams RJ, Brott T, et al. Guidelines for the early management of patients with ischemic stroke: a scientific statement from the Stroke Council of the American Stroke Association. Stroke. 2003;34:1056-1083.

    Article  PubMed  Google Scholar 

  31. The European Stroke Initiative Executive Committee and the EUSI Writing Committee. European Stroke Initiative recommendations for stoke management: update 2003. Cerebrovasc Dis. 2003;16:311-337.

    Article  Google Scholar 

  32. Qureshi AI, Harris-lane P, Kirmani JF, et al. Treatment of acute hypertention in patients with intracerebral hemorrhage using American Heart Association guidelines. Crit Care Med. 2006;34:1975-1980.

    Article  PubMed  Google Scholar 

  33. Sibai BM. Diagnosis, prevention, and management of eclampsia. Obstet Gynecol. 2005;105:402-410.

    Article  PubMed  Google Scholar 

  34. Gifford RW, August PA, Cunningham G. Report of the National High Blood Pressure Education Program Working Group on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;183:S1-S22.

    Google Scholar 

  35. Diagnosis and management of preeclampsia and eclampsia: ACOG Practice Bulletin No. 33. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2002;99:159-167.

    Article  Google Scholar 

  36. Mabie WC, Gonzalez AR, Sibai BM, et al. A comparative trial of labtalol and hydralazine in the acute management of severe hypertension complicating pregnancy. Obstet Gynecol. 1987;70:328-333.

    PubMed  CAS  Google Scholar 

  37. Elatrous S, Nouira S, Ouanes BL, et al. Short-term treatment of severe hypertension of pregnancy: prospective comparison of nicardipine and labetalol. Inten Care Med. 2002;28:1281-1286.

    Article  CAS  Google Scholar 

  38. Haas CE, LeBlanc JM, Haas CE, et al. Acute postoperative hypertension: a review of therapeutic options. Am J Health System Pharm. 2004;61:1661-1673.

    CAS  Google Scholar 

Additional Reading

  • Calhoun DA, Oparil S. Treatment of hypertensive crisis. N Engl J Med. 1990;323:1177-1183.

    Article  PubMed  CAS  Google Scholar 

  • Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. The JNC 7 report. JAMA. 2003;289(19):2560-2572.

    Article  PubMed  CAS  Google Scholar 

  • Flanigan JS, Vitberg D. Hypertension emergency and severe hypertension: what to treat, who to treat, and how to treat. Med Clin N Am. 2006;90(3):439-451.

    Article  PubMed  Google Scholar 

  • Marik PE, Varon J. Hypertensive crisis: challenges and management. Chest. 2007;131:1949-1962.

    Article  PubMed  CAS  Google Scholar 

  • Vaidya CK, Ouellette JR. Hypertensive urgency and emergency. Hosp Physician. 2007;43:43-50.

    Google Scholar 

  • Aggarwal M, Khan IA. Hypertensive crises: hypertensive emergencies and urgencies. Cardiol Clin. 2006;24:135-146.

    Article  PubMed  Google Scholar 

  • Herbert CJ, Vidt DG. Hypertensive crises. Prim Care Clin Office Pract. 2008;35:475-487.

    Article  Google Scholar 

  • Kitiyakara C, Guzman NJ. Malignant hypertension and hypertensive emergencies. J Am Soc Nephrol. 1998;9:133-142.

    PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, PA, 19140, USA

    Kathleen J. Brennan MD

  2. Department of Medicine, Section of Nephrology, Temple University School of Medicine, Philadelphia, PA, 19140, USA

    Jesse Goldman MD

  3. Pulmonary and Critical Care Medicine, Temple University School of Medicine, Philadelphia, PA, 19140, USA

    Gilbert E. D’Alonzo Do

Authors
  1. Kathleen J. Brennan MD
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  2. Jesse Goldman MD
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  3. Gilbert E. D’Alonzo Do
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Editor information

Editors and Affiliations

  1. School of Medicine, Temple University, N. Broad St. 3420, Philadelphia, 19140, USA

    Gerard J. Criner

  2. Dept. Medicine, Temple University, N. Broad Street 3401, Philadelphia, 19140, USA

    Rodger E. Barnette

  3. School of Medicine, Temple University, N. Broad St. 3420, Philadelphia, 19140, USA

    Gilbert E. D'Alonzo

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Brennan, K.J., Goldman, J., D’Alonzo, G.E. (2010). Hypertensive Crisis. In: Criner, G., Barnette, R., D'Alonzo, G. (eds) Critical Care Study Guide. Springer, New York, NY. https://doi.org/10.1007/978-0-387-77452-7_53

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  • DOI: https://doi.org/10.1007/978-0-387-77452-7_53

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-77327-8

  • Online ISBN: 978-0-387-77452-7

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