Overview
Hypertensive emergency is severe elevation in blood pressure accompanied by acute injury to organs such as the brain, heart, kidneys, or aorta.
The presence of acute target-organ injury, rather than the blood pressure number alone, defines the emergency.
Clinical Features
Symptoms may include headache, visual disturbance, chest pain, dyspnea, neurological deficit, confusion, seizures, or reduced urine output.
Investigation
Assessment should focus on identifying acute target-organ injury with ECG, renal testing, urinalysis, neurological evaluation, and imaging when indicated.
Management
Treatment generally requires monitored intravenous antihypertensive therapy with controlled reduction tailored to the clinical situation.
The underlying precipitating cause must also be treated.
Blood pressure should be lowered carefully rather than normalized abruptly.
Clinical Pearls
Hypertensive emergency means severe hypertension + acute target-organ injury.
END OF REVIEW
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