Hypertensive Crisis, its Complications and Medications Used in Hypertensive Crisis

Abstract

In clinical practice, patients with hypertensive emergencies, malignant hypertension, and acute severe hypertension are managed differently. Important considerations that vary slightly across different diagnoses and clinical contexts are necessary when starting antihypertensive therapy and setting blood pressure goals in acute settings. The British and Irish Hypertension Society's position paper aims to give clinicians a framework for diagnosing, evaluating, and managing patients with hypertensive crisis, based on the critical appraisal of available evidence and expert opinion. Only a small percentage of hypertensive patients will experience a hypertensive crisis, despite the high prevalence of hypertension (HTN). In actuality, some hypertensive crisis patients do not disclose a history of hypertension or prior antihypertensive medication use. While heart-related symptoms (dyspnea, chest discomfort, arrhythmias, and syncope) are less common, most patients with hypertensive crises frequently describe non-specific symptoms. Depending on whether there is acute target organ damage or not, hypertensive crises can be classified as either hypertension emergencies or hypertensive urgencies. Since a different approach to therapy is required, which has a substantial impact on the morbidity and mortality of these patients, this differentiation is a very helpful classification in clinical practice. Therefore, in order to prevent additional injury or deterioration of the target organs, it is extremely important for the emergency department physician to recognize hypertensive situations and treat them with blood pressure-lowering drugs. In an attempt to enhance the understanding, identification, risk assessment, and management of hypertensive crises in patients sent to the emergency room, this narrative review aims to provide an overview of the most recent data.