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Severely elevated blood pressure (equal to or greater than 180 mmHg systolic or 120 mmHg diastolic) is referred to as a hypertensive crisis (sometimes termed malignant or accelerated hypertension), due to the high risk of complications.
Hypertensive heart disease includes a number of complications of high blood pressure that affect the heart.While there are several definitions of hypertensive heart disease in the medical literature, [1] [2] [3] the term is most widely used in the context of the International Classification of Diseases (ICD) coding categories.
Not much is known about the epidemiology of hypertensive urgencies. Retrospective analysis of data from 1,290,804 adults admitted to hospital emergency departments in United States from 2005 through 2007 found that severe hypertension with a systolic blood pressure ≥180 mmHg occurred in 13.8% of patients. [10]
ICD-10 is the 10th revision of the International Classification of Diseases (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. [1]
Benign hypertension or benign essential hypertension are historical terms that are considered misleading, [1] as hypertension is never benign, and consequently they have fallen out of use (see history of hypertension). The terminology persisted in the International Classification of Disease (ICD9), but is not included in the current ICD10. [2]
Commonly, ischemic heart attack and stroke are the causes that lead to death in patients with severe hypertension. It is estimated that for every 20 mm Hg systolic or 10 mm Hg diastolic increase in blood pressures above 115/75 mm Hg, the mortality rate for both ischemic heart disease, cancer and stroke doubles. [citation needed]
The term resistant hypertension has been used since the early 1960s to identify patients with difficult-to-treat hypertension. In 2008, the American Heart Association defined resistant hypertension as blood pressure uncontrolled with 3 medications, but controlled with ≥4 medications. [3]
Autonomic dysreflexia (AD) is a potentially fatal medical emergency classically characterized by uncontrolled hypertension and cardiac arrhythmia. [2] [3] [4] AD occurs most often in individuals with spinal cord injuries with lesions at or above the T6 spinal cord level, although it has been reported in patients with lesions as low as T10. [5]