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A hypertensive emergency is very high blood pressure with potentially life-threatening symptoms and signs of acute damage to one or more organ systems (especially brain, eyes, heart, aorta, or kidneys). It is different from a hypertensive urgency by this additional evidence for impending irreversible hypertension-mediated organ damage (HMOD).
A hypertensive urgency is a clinical situation in which blood pressure is very high (e.g., 220/125 mmHg) with minimal or no symptoms, and no signs or symptoms indicating acute organ damage. [1] [2] This contrasts with a hypertensive emergency where severely high blood pressure is accompanied by evidence of progressive organ or system damage. [1]
When blood pressure creeps up so high that it causes potentially life-threatening symptoms, it may be a type of high blood pressure crisis known as a hypertensive emergency, says Stephen J. Huot ...
In hypertensive urgency, there is no evidence of end organ damage resulting from the elevated blood pressure. In these cases, oral medications are used to lower the BP gradually over 24 to 48 hours. [29] In hypertensive emergency, there is evidence of direct damage to one or more organs.
Stage 1 hypertension is between 140 and 159 mmHg on the systolic side, and between 90 and 99 on the diastolic side. Stage 2 hypertension is between 160 and 179 mmHg on the systolic side, and between 100 and 109 on the diastolic side. And finally, stage 3 hypertension is anything over 180 mmHg on the systolic side and 110 mmHg on the diastolic side.
Other symptoms accompanying a hypertensive crisis may include visual deterioration due to retinopathy, breathlessness due to heart failure, or a general feeling of malaise due to kidney failure. [3] Most people with a hypertensive crisis are known to have elevated blood pressure, but additional triggers may have led to a sudden rise. [4]
Any response to an emergency medical situation will depend strongly on the situation, the patient involved, and availability of resources to help them. It will also vary depending on whether the emergency occurs whilst in hospital under medical care, or outside medical care (for instance, in the street or alone at home).
Hypertension is usually treated to achieve a blood pressure of below 140/90 mmHg to 160/100 mmHg. According to one 2003 review, reduction of the blood pressure by 5 mmHg can decrease the risk of stroke by 34% and of ischaemic heart disease by 21% and reduce the likelihood of dementia , heart failure , and mortality from cardiovascular disease .