Management of Hypertensive Urgency and Emergency

CONCLUSION

Patients presenting with urgent or emergent hypertension need expeditious evaluation to avoid the significant morbidity and mortality associated with acute end-organ damage. Hypertensive urgency is defined as a diastolic blood pressure of greater than 120 mm Hg without evidence of end-organ damage.

In cases of hypertensive emergency, in which acute end-organ damage is present, lowering blood pressure should be directed by the type of end-organ damage and/or underlying comorbidities. In general, blood pressure should not be lowered more than 10% to 25% within the first hour, with normalization achieved over the next 8 to 24 hours.

In cases of acute ischemic stroke, permissive hypertension is recommended. Above all, treat patients, not numbers, bearing in mind the Hippocratic oath: Primum non nocere, or "First, do no harm."

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