Hypertensive Urgencies and Emergencies: Clinical Update
Published on: 2015-08-21
Hypertensive crisis is a common clinical situation characterized by the symptomatic rise of the blood pressure that presents a high rate of morbidity and mortality. It is classified in hypertensive emergency and urgency. The clinical picture of hypertensive emergency differs from that of hypertensive urgency by presenting an imminent death risk due to an established or developing lesion in target-organs, especially heart, brain, kidneys, and arteries. This condition requires a sensible clinical approach that allows correct and fast diagnosis of the compromised target-organ. The therapeutic intervention must be immediate, efficient, and individualized for each involved system, in general with anti-hypertensive drugs by endovenous route in an intensive care unit. On the other hand, the patient with hypertensive urgency does not present target-organ lesion nor finds himself/herself in a higher risk of death, therefore the treatment can be carried out with oral anti-hypertensive drugs in the appropriate urgency room. This article reviews the main causes of hypertensive crisis, its physio pathogenesis, and epidemiology, as well as its clinical and therapeutic approaching.