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Hypertensive Emergency (Crisis)

Emergency treatment of severe blood pressure elevation associated with target organ damage.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is Hypertensive Emergency (Crisis)?

A hypertensive emergency is an acute presentation in which blood pressure is generally >180/120 mmHg with accompanying acute target organ damage. In the absence of organ damage, it is defined as hypertensive urgency.

Acute aortic dissection, hypertensive encephalopathy, acute pulmonary edema, eclampsia, and hypertension accompanying acute MI are the most critical scenarios. The goal in the first hour is to lower MAP by no more than 25% with IV antihypertensive therapy.

Symptoms

Severe headache
Visual disturbances
Chest pain or shortness of breath
Neurological deficits (encephalopathy, stroke)
Epistaxis (nosebleed)
Oliguria (kidney damage)

Risk Factors

Treatment non-compliance (medication discontinuation)
Pheochromocytoma
Renal artery stenosis
Preeclampsia/eclampsia
Cocaine or amphetamine use
Autonomic hyperreflexia (spinal cord injury)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • SBP >180 and/or DBP >120 mmHg + organ damage findings — EMERGENCY
  • Hypertension with chest pain or shortness of breath
  • Neurological symptoms (headache, vision loss, hemiparesis)

Treatment Methods

01
IV nicardipine (first choice in coronary syndrome and general emergencies)
02
IV nitroprusside (when rapid action is needed — risk of cyanide toxicity)
03
IV labetalol (in aortic dissection — heart rate control)
04
IV nitroglycerin (in acute coronary syndrome)
05
IV phentolamine (in pheochromocytoma crisis)
06
First-hour goal: do not lower MAP by more than 25%

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.