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[9] 25% of hypertensive crises have been found to be hypertensive emergency versus urgency when presenting to the ER. [11] Risk factors for hypertensive emergency include age, obesity, noncompliance to anti hypertensive medications, female sex, Caucasian race, preexisting diabetes or coronary artery disease, mental illness, and sedentary ...
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 .
Essential hypertension (also called primary hypertension, or idiopathic hypertension) is a form of hypertension without an identifiable physiologic cause. [1] [2] It is the most common type affecting 85% of those with high blood pressure. [3] [4] The remaining 15% is accounted for by various causes of secondary hypertension. [3]
Aortic dissection generally presents as a hypertensive emergency, and the prime consideration of medical management is to decrease the shear stress in the aortic wall (dP/dt (force of ejection of blood from the left ventricle)) by decreasing blood pressure and the heart rate.
The Emergency Medicine Journal is a monthly peer-reviewed medical journal that is published by the BMJ Group on behalf of the Royal College of Emergency Medicine of which it is an official journal [1] It is also an official journal of the British Association for Immediate Care and the Faculty of Pre-Hospital Care of the Royal College of Surgeons of Edinburgh.
BMJ Best Practice is an online decision-support tool made for clinical decision making support. It was created in 2009 by BMJ. [1] Development
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]
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.