2013
DOI: 10.1186/2110-5820-3-17
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Control of hypertension in the critically ill: a pathophysiological approach

Abstract: Severe acute arterial hypertension can be associated with significant morbidity and mortality. After excluding a reversible etiology, choice of therapeutic intervention should be based on evaluation of a number of factors, such as age, comorbidities, and other ongoing therapies. A rational pathophysiological approach should then be applied that integrates the effects of the drug on blood volume, vascular tone, and other determinants of cardiac output. Vasodilators, calcium channel blockers, and beta-blocking a… Show more

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Cited by 32 publications
(22 citation statements)
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“…40 Higher blood pressure can also have negative consequences on the heart and kidneys and is associated with mortality. 41 In the subgroup analysis, delta-BNP levels from D0 to D1 remained a useful predictor of mortality in septic patients.…”
Section: Discussionmentioning
confidence: 99%
“…40 Higher blood pressure can also have negative consequences on the heart and kidneys and is associated with mortality. 41 In the subgroup analysis, delta-BNP levels from D0 to D1 remained a useful predictor of mortality in septic patients.…”
Section: Discussionmentioning
confidence: 99%
“…To achieve this goal, rapidly decrease the heart rate to approximately 60 beats/min with beta-blocker medication [15,16]. The primary goal is to decrease shear forces on the torn aortic wall to prevent further propagation of the dissection or aortic rupture.…”
Section: Aortic Dissectionmentioning
confidence: 99%
“…The primary goal is to decrease shear forces on the torn aortic wall to prevent further propagation of the dissection or aortic rupture. A number of antihypertensive medications can be used to achieve SBP reduction: labetalol, combination of nicardipine and esmolol, and combination of sodium nitroprusside and esmolol [15][16][17][18]. Recommended beta-blocker medications for AD include esmolol and labetalol [15][16][17].…”
Section: Aortic Dissectionmentioning
confidence: 99%
“…In a recent American survey of patients with severe acute hypertension (defined as systolic arterial pressure [SAP] >180 mmHg and/or diastolic arterial pressure [DAP] >110 mmHg) requiring hospitalization, new or worsening end-organ dysfunction was observed in 59% of subjects; the 90-day mortality rate was 11%. More than one third of patients discharged home were re-hospitalized at least once within 90 days, 29% for acute severe hypertension [3,4].…”
Section: Overview Of Hypertensive Urgency and Its Managements The Evimentioning
confidence: 99%
“…Another cause for patients reaching hypertensive urgency or emergency is previous inaccurate BP measurements that underestimate or do not detect increased BP at all (e.g. Poor patient technique for self-monitoring) [4][5][6].…”
Section: What Causes Hypertensive Urgency?mentioning
confidence: 99%