Hypertensive Crisis

Abstract

Hypertension is a common disease, affecting about 60 million people in the United States alone. Hypertensive crisis, defined as a severe elevation in systemic blood pressure, has an annual incidence of 1% in the general population but accounts for 27% of emergency room admissions. Hypertensive crisis can be divided into hypertensive emergency and hypertensive urgency. Hypertensive emergency is defined as a severe elevation in blood pressure accompanied by signs of end-organ damage (brain, heart, or kidneys). Hypertensive emergencies require rapid control of blood pressure, usually with intravenous medications and intensive care monitoring. Hypertensive urgencies are elevations in blood pressure, without acute end-organ damage, that can usually be treated with oral medications. The main distinction between hypertensive emergency and urgency is the presence of end-organ damage, not the magnitude of elevation in blood pressure. The term malignant hypertension is used to describe a hypertensive emergency with associated encephalopathy.