A site for medical students - Practical,Theory,Osce Notes

>

What is Hypertensive Emergency?

A hypertensive emergency exists when blood pressure of the patient reaches levels that are damaging vital organs. The systems which are primarily involved are the central nervous system, the cardiovascular system, and the renal system Hypertensive emergencies generally occur when the blood pressure levels exceeds 180 mm Hg systolic OR 120 mm diastolic, but it can occur at even at lower levels in patients whose blood pressure was previously normal
The hypertensive emergencies include 
  • Malignant hypertension 
  • Accelerated hypertension
Both of them have similar therapy and outcome
The consequences of uncontrolled blood pressure in this range can be severe and include
  • Stroke Cerebro vascular accident
  • Loss of consciousness
  • Memory loss
  • Heart attack CAD
  • Damage to the eyes and kidneys
  • Loss of kidney function
  • Aortic dissection
  • Angina (unstable chest pain)
  • Pulmonary edema (fluid backup in the lungs)
  • Eclampsia
Hypertensive emergencies require immediate therapy to lower the blood pressure within minutes to hours.In contrast,there are no evidences to suggests a benefit from rapid reduction of blood pressure in patients with hypertensive urgency, such aggressive therapy may harm the patient, due to cardiac, renal, or cerebral hypoperfusion.