Hypertensive Crises

Ram, C. Venkata S.; Hyman, David M.

doi:10.1177/088506668700200305

Cited by 7 publications

(4 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The main determinants are the level of blood pressure and the clinical manifestations rather than the cause of the hypertension [1,2]. One feature in the development of certain types of hypertensive crises is the abruptness with which the blood pressure rises; this factor sometimes seems more important than the absolute level of blood pressure.…”

Section: Introductionmentioning

confidence: 99%

Treatment of hypertensive urgencies and emergencies

Ram

Silverstein²

2009

Current Science Inc

Self Cite

View full text Add to dashboard Cite

Although systemic hypertension is a common clinical condition, hypertensive emergencies are unusual in clinical practice. There are some situations, however, that qualify as hypertensive emergencies or urgencies. It is important, therefore, to diagnose these acute conditions, in which immediate treatment of hypertension is indicated. The diagnosis of hypertensive emergencies depends on consideration of the clinical manifestations as well as the absolute level of blood pressure. Manifestations of hypertensive emergencies can be quite profound, but they vary depending on the target organ that is affected. Thus, an accurate clinical diagnosis is necessary to render appropriate therapy. Fortunately, effective drug therapy is available to lower the blood pressure quickly in hypertensive emergencies. Physicians should be familiar with the pharmacologic and clinical actions of drugs in treating hypertensive emergencies. With proper clinical diagnosis, hypertensive emergencies can be successfully treated, and complications can be largely prevented with timely intervention.

show abstract

Section: Introductionmentioning

confidence: 99%

Treatment of hypertensive urgencies and emergencies

Ram

Silverstein²

2009

Current Science Inc

Self Cite

View full text Add to dashboard Cite

show abstract

“…1,2 One feature in the development of certain forms of hypertensive crises is the abruptness with which the blood pressure increases because this factor seems to be more important than the absolute level of blood pressure. In some (but not all) clinical circumstances, immediate reduction of blood pressure is indicated not because of its absolute level but because the coexisting complications (eg, aortic dissection, renal failure, acute left ventricular failure) may make any degree of hypertension dangerously high.…”

mentioning

confidence: 99%

Drug Treatment of Hypertensive Urgencies and Emergencies

Fenves

Ram

2005

Seminars in Nephrology

Self Cite

View full text Add to dashboard Cite

“…

Medicine Ram and Hyman discuss the treatment of hypertensive emergencies [1]. As I read this article several thoughts came to mind.

…”

mentioning

confidence: 99%

“…J Intensive Care Med 1987; 2:123-125. In this issue of the Journal of Intensive Care Medicine Ram and Hyman discuss the treatment of hypertensive emergencies [1]. Hypertensive emergencies: a paradigm for tailoring antihypertensive therapy.…”

mentioning

confidence: 99%

Hypertensive Emergencies: A Paradigm for Tailoring, Antihypertensive Therapy

Fröhlich

1987

J Intensive Care Med

View full text Add to dashboard Cite

Medicine Ram and Hyman discuss the treatment of hypertensive emergencies [1]. As I read this article several thoughts came to mind. First was the feeling of amazement that it was not so long ago when we approached the problem of a patient with a hypertensive emergency with only one or two alternative means of therapy; and in the final analysis, the treatment was not always uniformly successful.We can look back to the dramatic reversal in the course of the natural history of the disease when we see the remarkable improvement in the fiveyear survival of patients with malignant and accelerated hypertension [2,3]. The Veterans Administration Cooperative Study Group demonstrated the prevention not only of deaths from the progression of disease (as evidenced by the lack of deaths from the manifestations of necrotizing arteriolitis), but also of the cardiovascular complications of hypertension (i.e., congestive heart failure and acute aortic dissection) [4,5]. National health statistics have clearly demonstrated the impressive prevention rates of deaths from acute cerebral vascular incidents; there has been a 48% reduction in the number of deaths from strokes since 1972 [6].The second point that struck me was the tremendous sastisfaction to be derived from the recognition that we are no longer in the position of selecting from one or even a handful of potent, but less than optimal, agents that effectively control arterial pressure (Table 1). A scant decade ago we longed for newer, more effective, more specific, and more potent agents that control arterial pressure with fewer side effects. This wish has now come true so that it is actually possible to tailor antihypertensive drug therapy to suit the hypertensive emergency [7]. We should no longer approach this problem as a question of, &dquo;How do we treat the hypertensive emergency?&dquo; Rather, we can more appropriately ask, &dquo;How do we treat the variety of conditions that constitute the variety of hypertensive emergencies ?&dquo; (See Table 2.)Considerations about the treatment of hypertension have evolved over the past decade [8][9][10]. Initially, we have seen the recommendations from the Joint National Committee to approach the treatment of nonemergent forms of hypertension by a rather straightforward algorithm (i.e., the &dquo;Stepped Care Approach&dquo; for treating patients with essential hypertension). According to this approach all patients were treated initially with a diuretic; other agents were introduced sequentially depending on whether the problem was more increasingly severe, requiring further drug therapy [8]. The most recent report provides several options for the initial treatment of the patient with hypertension [10].

show abstract

Hypertensive Crises

Cited by 7 publications

References 52 publications

Treatment of hypertensive urgencies and emergencies

Treatment of hypertensive urgencies and emergencies

Drug Treatment of Hypertensive Urgencies and Emergencies

Hypertensive Emergencies: A Paradigm for Tailoring, Antihypertensive Therapy

Contact Info

Product

Resources

About