Review
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Year 2021, Volume: 43 Issue: 3, 201 - 206, 30.09.2021
https://doi.org/10.7197/cmj.963044

Abstract

References

  • Stanaway JD et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Stu. Lancet 392, 1923–1994 (2018)
  • Mills KT et al. Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. Circulation 134, 441–450 (2016).
  • Patel P, Ordunez P, Connell K, Lackland D, DiPette D; Standardized Hypertension Treatment and Prevention Network. Standardized Hypertension Management to Reduce Cardiovascular Disease Morbidity and Mortality Worldwide. South Med J. 2018;111(3):133-136. doi:10.14423/SMJ.0000000000000776
  • Salkic S, Batic-Mujanovic O, Ljuca F, Brkic S. Clinical presentation of hypertensive crises in emergency medical services. Mater Sociomed. 2014;26(1):12-16. doi:10.5455/msm.2014.26.12-16
  • Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension [published correction appears in J Hypertens. 2019 Jan;37(1):226]. J Hypertens. 2018;36(10):1953-2041. doi:10.1097/HJH.0000000000001940
  • Astarita A, Covella M, Vallelonga F, et al. Hypertensive emergencies and urgencies in emergency departments: a systematic review and meta-analysis. J Hypertens. 2020;38(7):1203-1210. doi:10.1097/HJH.0000000000002372
  • Kotchen TA. Historical trends and milestones in hypertension research: a model of the process of translational research. Hypertension. 2011;58(4):522-538. doi:10.1161/HYPERTENSIONAHA.111.177766
  • Vallelonga F, Carbone F, Benedetto F, et al. Accuracy of a Symptom-Based Approach to Identify Hypertensive Emergencies in the Emergency Department. J Clin Med. 2020;9(7):2201. Published 2020 Jul 12. doi:10.3390/jcm9072201
  • Ede H., Derya MA., Ardahanlı İ.,et al. HİPERTANSİF HASTALARDA NABIZ BASINCI ARALIĞI İLE SOL VENTRİKÜL DİASTOLİK FONKSİYON İLİŞKİSİ Association of Pulse Pressure Index with Left Ventricular Diastolic Function in Hypertensive Patients. Bozok Med J. 2015;5(2), 24-30.
  • Brenner BM, Rector FC. Brenner & Rector’s the kidney. 10th edition. Philadelphia: Saunders Elsevier; 2016
  • Satheeshkumar A, Pena C, Nugent K. Current U.S. Guideline-Based Management Strategies for Special Clinical Situations Involving Hypertensive Crises: A Narrative Review of the Literature [published online ahead of print, 2020 Oct 19]. Cardiol Rev. 2020;10.1097/CRD.0000000000000364. doi:10.1097/CRD.0000000000000364
  • Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-1252. doi:10.1161/01.HYP.0000107251.49515.c2
  • Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension global hypertension practice guidelines. J Hypertens. 2020;38(6):982-1004. doi:10.1097/HJH.0000000000002453
  • Arbe G, Pastor I, Franco J. Diagnostic and therapeutic approach to the hypertensive crisis. Aproximación diagnóstica y terapéutica de las crisis hipertensivas. Med Clin (Barc). 2018;150(8):317-322. doi:10.1016/j.medcli.2017.09.027
  • Arıkan E , Arıkan N , Aktaş A , Ardahanlı İ . Asemptomatik Tansiyon Yüksekliğine Acil Tıp Asistanlarının Yaklaşımının Değerlendirilmesi. Turkish Journal of Science and Health. (2021);2(2), 72-81. doi: 10.51972/tfsd.892363
  • O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the American College of Emergency Physicians and Society for Cardiovascular Angiography and Interventions. Catheter Cardiovasc Interv. 2013;82(1):E1-E27. doi:10.1002/ccd.24776

Hypertensive emergency and hypertensive urgency management in the emergency department

Year 2021, Volume: 43 Issue: 3, 201 - 206, 30.09.2021
https://doi.org/10.7197/cmj.963044

Abstract

Hypertension (HT) is a serious public health problem with an increasing prevalence all over the world. It is a significant cause of mortality and morbidity due to the complications it causes in the short and long term. The majority of applications to emergency departments are due to HT. Hypertensive crisis is defined as systolic blood pressure ≥ 180 mmHg and/or diastolic blood pressure ≥ 120 mmHg. It is evaluated under two separate headings according to the presence of target organ damage (TOD) accompanying these values. If TOD accompanies, it is defined as hypertensive emergency; if TOD is not present, it is defined as hypertensive urgency. Whether or not there is end-organ damage is the most important key point in the management of treatment. In hypertensive emergencies, treatment should be rapid to prevent target organ damage. For this purpose, emergency intravenous treatment should be applied, and the patient should be followed up under intensive care conditions for close hemodynamic follow-up. It has been shown that rapid blood pressure reduction in hypertensive urgency does not contribute to mortality and morbidity in the short term. In fact, it is not recommended because it is known that sudden lowering of blood pressure may cause hypoperfusion. For this purpose, oral antihypertensives are administered for treatment in hypertensive urgency and it is aimed to reach the target blood pressure values within days.

References

  • Stanaway JD et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Stu. Lancet 392, 1923–1994 (2018)
  • Mills KT et al. Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. Circulation 134, 441–450 (2016).
  • Patel P, Ordunez P, Connell K, Lackland D, DiPette D; Standardized Hypertension Treatment and Prevention Network. Standardized Hypertension Management to Reduce Cardiovascular Disease Morbidity and Mortality Worldwide. South Med J. 2018;111(3):133-136. doi:10.14423/SMJ.0000000000000776
  • Salkic S, Batic-Mujanovic O, Ljuca F, Brkic S. Clinical presentation of hypertensive crises in emergency medical services. Mater Sociomed. 2014;26(1):12-16. doi:10.5455/msm.2014.26.12-16
  • Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension [published correction appears in J Hypertens. 2019 Jan;37(1):226]. J Hypertens. 2018;36(10):1953-2041. doi:10.1097/HJH.0000000000001940
  • Astarita A, Covella M, Vallelonga F, et al. Hypertensive emergencies and urgencies in emergency departments: a systematic review and meta-analysis. J Hypertens. 2020;38(7):1203-1210. doi:10.1097/HJH.0000000000002372
  • Kotchen TA. Historical trends and milestones in hypertension research: a model of the process of translational research. Hypertension. 2011;58(4):522-538. doi:10.1161/HYPERTENSIONAHA.111.177766
  • Vallelonga F, Carbone F, Benedetto F, et al. Accuracy of a Symptom-Based Approach to Identify Hypertensive Emergencies in the Emergency Department. J Clin Med. 2020;9(7):2201. Published 2020 Jul 12. doi:10.3390/jcm9072201
  • Ede H., Derya MA., Ardahanlı İ.,et al. HİPERTANSİF HASTALARDA NABIZ BASINCI ARALIĞI İLE SOL VENTRİKÜL DİASTOLİK FONKSİYON İLİŞKİSİ Association of Pulse Pressure Index with Left Ventricular Diastolic Function in Hypertensive Patients. Bozok Med J. 2015;5(2), 24-30.
  • Brenner BM, Rector FC. Brenner & Rector’s the kidney. 10th edition. Philadelphia: Saunders Elsevier; 2016
  • Satheeshkumar A, Pena C, Nugent K. Current U.S. Guideline-Based Management Strategies for Special Clinical Situations Involving Hypertensive Crises: A Narrative Review of the Literature [published online ahead of print, 2020 Oct 19]. Cardiol Rev. 2020;10.1097/CRD.0000000000000364. doi:10.1097/CRD.0000000000000364
  • Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-1252. doi:10.1161/01.HYP.0000107251.49515.c2
  • Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension global hypertension practice guidelines. J Hypertens. 2020;38(6):982-1004. doi:10.1097/HJH.0000000000002453
  • Arbe G, Pastor I, Franco J. Diagnostic and therapeutic approach to the hypertensive crisis. Aproximación diagnóstica y terapéutica de las crisis hipertensivas. Med Clin (Barc). 2018;150(8):317-322. doi:10.1016/j.medcli.2017.09.027
  • Arıkan E , Arıkan N , Aktaş A , Ardahanlı İ . Asemptomatik Tansiyon Yüksekliğine Acil Tıp Asistanlarının Yaklaşımının Değerlendirilmesi. Turkish Journal of Science and Health. (2021);2(2), 72-81. doi: 10.51972/tfsd.892363
  • O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the American College of Emergency Physicians and Society for Cardiovascular Angiography and Interventions. Catheter Cardiovasc Interv. 2013;82(1):E1-E27. doi:10.1002/ccd.24776
There are 16 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Reviews
Authors

Erhan Arıkan 0000-0002-4800-3206

Publication Date September 30, 2021
Acceptance Date August 20, 2021
Published in Issue Year 2021Volume: 43 Issue: 3

Cite

AMA Arıkan E. Hypertensive emergency and hypertensive urgency management in the emergency department. CMJ. September 2021;43(3):201-206. doi:10.7197/cmj.963044