Hypertensive emergencies – Interesting Facts

5 Interesting Facts of Hypertensive emergencies

1. Hypertensive emergencies are clinical scenarios in which acute target-organ damage is progressive and requires blood pressure to be reduced gradually and safely within minutes to hours.

2. The most common clinical scenarios that qualify as hypertensive emergencies include acute myocardial infarction, pulmonary edema, intracranial hemorrhage, glomerulonephritis, eclampsia, adrenergic crisis, uncontrolled bleeding, or hypertensive encephalopathy.

3. In hypertensive emergencies the treatment goal is to lower blood pressure by about 10% in the first hour and a further 10% to 15% in the next hour. Do not target a blood pressure of <140/90 mm Hg in the hours after presentation.

4. Although one of many intravenous antihypertensive drugs can be used for hypertensive emergencies, the pharmacokinetic advantages of sodium nitroprusside (very short onset of action, very short elimination half-life) usually outweigh the risk of cyanide or thiocyanate poisoning, which are more common with high doses or long durations of therapy.

5. Acute aortic dissection differs from all other hypertensive emergencies because the recommended systolic blood pressure target is <120 mm Hg within 20 minutes of diagnosis and an intravenous beta blocker is used to decrease the shear stress on the ruptured intimal flap.

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