Hypertensive emergencies: an update

Curr Opin Crit Care. 2011 Dec;17(6):569-80. doi: 10.1097/MCC.0b013e32834cd31d.


Purpose of review: Systemic hypertension (HTN) is a common medical condition affecting over 1 billion people worldwide. One to two percent of patients with HTN develop acute elevations of blood pressure (hypertensive crises) that require medical treatment. However, only patients with true hypertensive emergencies require the immediate and controlled reduction of blood pressure with an intravenous antihypertensive agent.

Recent findings: Although the mortality from hypertensive emergencies has decreased, the prevalence and demographics of this disorder have not changed over the last 4 decades. Clinical experience and reported data suggest that patients with hypertensive urgencies are frequently inappropriately treated with intravenous antihypertensive agents, whereas patients with true hypertensive emergencies are overtreated with significant complications.

Summary: Despite published guidelines, most patients with hypertensive crises are poorly managed with potentially severe outcomes.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Adrenergic beta-Antagonists / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure
  • Critical Care / methods*
  • Critical Illness*
  • Emergency Medical Services / methods*
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Labetalol / therapeutic use
  • Nicardipine / therapeutic use
  • Prevalence
  • Propanolamines / therapeutic use
  • United States / epidemiology


  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Propanolamines
  • Nicardipine
  • esmolol
  • Labetalol