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.

What is Hypertensive Urgency?

Hypertensive urgency is a situation where the blood pressure of patient is severely elevated with systolic BP 180 mm of Hg or diastolc BP 110 or higher, but there is no associated organ damage.Those patient with hypertensive urgency may or may not experience one or more of these symptoms:

• Severe headache
• Shortness of breath 
• Nosebleeds
• Severe anxiety

How to treat hypertensive urgency?

Treatment of hypertensive urgency requires readjustment and/or additional antihypertensive medications, but most of the time does not necessitate hospitalization for rapid lowering of blood pressure. But if the blood pressure reading is more than 180/110 or greater requires immediate evaluation, because early evaluation of organ function and blood pressure elevations is required to determine the appropriate management.