Abstract
Hypertensive emergencies and urgencies need prompt diagnosis and management because they may potentiate organ dysfunction and even lead to death if not appropriately treated (1-8). The goal of initial treatment in these patients is to obtain a safe and controlled reduction in blood pressure (BP) to a more physiologic, noncritical level, but not necessarily to a normotensive state. The initial examination should include careful fundoscopic, mental status, and cardiovascular evaluation. A true hypertensive emergency (e.g., malignant hypertension) is usually defined in the setting of a diastolic BP (DBP) >130 mmHg. This is especially true if it is accompanied by altered mental status papilledema, myocardial infarction (MI), pulmonary edema, evolving stroke, or a dissecting aneurysm (Table 40-1).
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References
Gifford RW Jr (1991) Management of the hypertension crisis. JAMA 266: 829–835.
Calhoun DA, Oparil S (1990) Treatment of hypertensive crisis. N Engl J Med 323: 1177–1183.
Phillips SJ, Whisnant JP (1992) Hypertension and the brain. The National High Blood Pressure Education Program. Arch Intern Med 152: 938–945.
Beilin LJ, Puddy IB (1992) Alcohol and hypertension. Clin Exp Hypertens A14:119— 138.
Schnall PL, Schwartz JE, Landsbergis PA, Warren K, Pickering TG (1992) Relation between job strain, alcohol, and ambulatory blood pressure. Hypertension 19: 488494.
Prisant LM, Can AA, Hawkins DW (1993) Treating Hypertensive emergencies: controlled reduction of blood pressure and protection of target end organs. Postgrad Med 93: 92–110.
Murphy C (1995) Hypertensive emergencies. Emerg Med Clin North Am 13:9731007.
The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (1997) Arch Intern Med 157(21):2413–2446.
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Sowers, D.K. (2001). Hypertensive Emergencies. In: Weber, M.A. (eds) Hypertension Medicine. Current Clinical Practice. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-008-7_40
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DOI: https://doi.org/10.1007/978-1-59259-008-7_40
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-4757-5446-9
Online ISBN: 978-1-59259-008-7
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