Hypertensive emergencies

Abstract

Introduction: The term hypertensive crisis entails a diversity of clinical situations that differ according to the severity of blood pressure values and the need to reduce more or less rapidly those values. This entity is arbitrarily defined as any increa se above 120mmHg of the diastolic blood pressure, with associated related symptoms. Depending on whether the existing target organ lesion is acute or rapidly progressive, the hypertensive crisis may manifest itself as an hypertensive urgency or hypertensive emergency. Goals:We aim to present a brief revision of the basic concepts concerning the identity of a real hypertensive crisis (hypertensive urgency or emergency), how to distinguish it from a pseudo-crisis, the diagnostic progress of this pathology and the correct therapy to apply. Methods: Bibliographic review, including reference studies and recently published articles on the subject of hypertension, specifically those focused on hypertensive urgencies and emergencies. Conclusions: Hypertensive urgencies and emergencies are also called hypertensive crisis and both are characterised b y a suddenand symptomatic increase in blood pressure which may or may not be associated to a target organ lesion and/or involve an immediate or potential risk of death. The patient in a situation of hypertensive emergency, if considered to be in a serious and/or acute state, must be interned in a healthcare unit, with continuous and cautious blood pressure monitorization; the blood pressure must be reduced within minutes or hours.The reduction needs not accomplish normal values but merely values that may withdraw the risk of death and put a stop to the aggravation or deterioration of the target organ. Hypertensive urgencies are defined as increases of the systolic and/or diastolic blood pressure without evidence of short-term target organ lesion; a gradual blood pressure reduction within 24-48 hour is of necessity so that the patients recuperation and readaptation may be attained.