Hypertensive Emergencies in the Emergency Department

Emerg Med Clin North Am. 2015 Aug;33(3):539-51. doi: 10.1016/j.emc.2015.04.005. Epub 2015 May 30.

Abstract

Hypertension affects approximately one-third of Americans. An additional 30% are unaware that they harbor the disease. Significantly increased blood pressure constitutes a hypertensive emergency that could lead to end-organ damage. When organs such as the brain, heart, or kidney are affected, an intervention that will lower the blood pressure in several hours is indicated. Several pharmacologic options are available for treatment, with intravenous antihypertensive therapy being the cornerstone, but there is no standard of care. Careful consideration of each patient's specific complaint, history, and physical examination guides the emergency physician through the treatment algorithm.

Keywords: Hypertension; Hypertensive crisis; Hypertensive emergency.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Aortic Dissection / drug therapy
  • Comorbidity
  • Emergencies
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Hypertension / complications*
  • Hypertension / diagnosis
  • Hypertension / etiology
  • Hypertension / therapy
  • Hypertensive Encephalopathy / drug therapy
  • Myocardial Ischemia / drug therapy
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / drug therapy
  • Pulmonary Edema / drug therapy

Substances

  • Antihypertensive Agents