An Emergency Department Approach to Drug Treatment of Hypertensive Urgency and Emergency

Abstract

Patients who present with hypertensive urgency or emergency require immediate attention to assess the severity of illness. Guidelines from the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure are available but do little to address the management of acute elevations in blood pressure. Various treatment options, both old and new, exist to manage these patients in the emergency department. Decisions on therapy are patient specific and depend on the underlying cause of elevated blood pressure. This article sets out to describe specific patient presentations and reviews current available options in the management of hypertensive urgencies and emergencies.

Oral drugs for hypertensive urgencies: systematic review and meta-analysis

“…9 Excessively rapid reductions in BP have been associated with acute deterioration in renal function and ischemic cardiac or cerebral events. 11 Most patients with severe BP elevation can be managed on an outpatient basis with oral agents and appropriate follow-up within 24 hours to several days, depending on the individual characteristics of the patient. 9 The initial goal for BP reduction is not to attain normal blood pressure but, rather, to achieve a progressive, controlled reduction in BP in order to minimize the risk of hypoperfusion in the cerebral, coronary and renovascular regions.…”