Systemic HypertensionPaleerat Jariyakanjana, MD
Faculty of MedicineNaresuan University
28 Mar 2014
Definition of Terms
Definition of Terms
Hypertensive crises hypertensive urgencyhypertensive emergency
Definition of Terms
Hypertensive emergencyacute elevation of blood pressure
(≥180/120 mm Hg) associated with end-organ damage
Definition of Terms
Definition of Terms
Definition of Terms
Hypertensive urgencysevere elevations in blood pressure
without progressive target organ dysfunction
Diagnosis
Validity of ED-Identified Hypertensionfew blood pressure changes occurred
after 20 minutes from ED arrivalblood pressure measurements at 60-
80 minutes after arrival may be the most predictive of chronic hypertension
Treatment
Emergency: MAP by 25% in mins-2 h w/ IV agents; goal DBP <110 w/in 2–6 h, as tolerated
Urgency: BP in hours using PO agents; goal normal BP in 1–2 d
Pocket medicine, 4th edition
Treatment
Treatment
Treatment
Treatment
Pocket medicine, 4th edition
Disposition and Follow-Up
Disposition and Follow-Up
Recommendations for initial therapy thiazide diuretic: HCTZ (25) 1x1 ACEIs: lisinopril (10) 1x1
Disposition and Follow-Up
Disposition and Follow-Up
Reference
Tintinalli's Emergency Medicine, 7th edition
Pocket medicine, 4th edition
ANY QUESTIONS?
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