Hypertensive Emergencies

Elliott, W.J.

doi:10.1016/s0749-0704(05)70176-7

Cited by 31 publications

(10 citation statements)

References 38 publications

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“…This possibility is revealed in the Framingham study, which showed that the incidence of coronary arterial disease in men increased in an almost linear mode as age increased. 9 The proportions of males were higher when studying the group of patients less than 50 years of age. Majority of female patients belonged to the postmenopausal age group which shows susceptibility of postmenopausal age to end organ damage.…”

Section: Outcomementioning

confidence: 93%

Clinical Study of Hypertensive Emergencies in Rural Hospital

Srinivas¹,

Nagula²

2014

jemds

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BACKGROUND AND OBJECTIVES:The clinical profile of patients with hypertensive emergencies presenting to rural hospitals in a developing country like ours is unknown. The objective of the present study was to evaluate the modes of presentations, clinical profile and spectrum of target organ damage in patients with hypertensive emergencies. METHOD: This observational study was done at SRI ADICHUNCHANGIRI INSTITUTE OF MEDICAL SCIENCES AND REASEARCH CENTER over a period of one and a half years. The study population included patients admitted to this hospital with severely elevated blood pressure with clinical or laboratory evidence of acute target organ damage. The clinical and laboratory profile of 50 patients were evaluated. RESULTS: Males had higher chances of developing a hypertensive emergency compared to females, male: female ratio 2.57:1. The commonest presenting symptoms were neurological deficit (50%), dyspnea (30%), followed by chest pain (24%). Majority of the patients were known hypertensive (70%). Higher levels of blood pressure at presentation were associated with an adverse outcome. Laboratory abnormalities noticed in these patients included hyponatremia and hyperkalemia. Acute intracerebral hemorrhage was the commonest mode of target organ damage. An in hospital mortality of 24% was observed in the present study. INTRODUCTION:Hypertension affects individuals of all classes and across all age groups. The prevalence of hypertension increases with advancing age to the point where more than half of people of 60-69 years of age and approximately three-fourths of those 70 years of age and older are affected. 1 The age related rise in SBP is primarily responsible for an increase in both incidence and prevalence of hypertension with increasing age. 1 The relationship between blood pressure and risk of cardiovascular disease events is continuous, consistent and independent of other risk factors. 1 Hypertension affects approximately one billion individuals worldwide as per the observations made by the Joint national committee on prevention, detection, evaluation and treatment of high blood pressure (JNC VII) report in 2003. 1 Higher than optimal blood pressure is the number one attributable risk for death throughout the world and approximately 7.1 million deaths per year are attributed to uncontrolled hypertension. 2 Target organ damage resulting from hypertension includes those affecting the brain, heart, kidneys and the eyes. A number of cardiovascular, pulmonary and neurological symptoms are found to be associated with patients in hypertensive emergency with target organ involvement. 3 Focal neurological deficits, dyspnea, chest pain, headache, loss of vision, are considered as the commonest symptoms with which patients in hypertension related acute target organ damage present. 3 As population ages the prevalence of hypertension will increase even further unless broad and effective preventive measures are implemented. 1

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Section: Outcomementioning

confidence: 93%

Clinical Study of Hypertensive Emergencies in Rural Hospital

Srinivas¹,

Nagula²

2014

jemds

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“…Rapid treatment of severe hypertension produces prompt, dramatic, and significant relief of symptoms of hypertensive encephalopathy [7,8]. The most important goal of therapy is to prevent permanent neurologic damage, and thus blood pressure should be closely monitored.…”

Section: Hypertensive Encephalopathymentioning

confidence: 99%

Treatment of hypertensive urgencies and emergencies

Ram

Silverstein²

2009

Current Science Inc

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Although systemic hypertension is a common clinical condition, hypertensive emergencies are unusual in clinical practice. There are some situations, however, that qualify as hypertensive emergencies or urgencies. It is important, therefore, to diagnose these acute conditions, in which immediate treatment of hypertension is indicated. The diagnosis of hypertensive emergencies depends on consideration of the clinical manifestations as well as the absolute level of blood pressure. Manifestations of hypertensive emergencies can be quite profound, but they vary depending on the target organ that is affected. Thus, an accurate clinical diagnosis is necessary to render appropriate therapy. Fortunately, effective drug therapy is available to lower the blood pressure quickly in hypertensive emergencies. Physicians should be familiar with the pharmacologic and clinical actions of drugs in treating hypertensive emergencies. With proper clinical diagnosis, hypertensive emergencies can be successfully treated, and complications can be largely prevented with timely intervention.

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“…cAMP also inhibits the sodium-hydrogen exchanger and the sodium/potassium-ATPase pump in the renal tubule. Thus, fenoldopam has the advantage of maintaining or increasing renal perfusion and has also been associated with short-term increases in urine output and creatinine clearance [36]. Disadvantages include the development of tolerance with use for greater than 48 hours and the potential to increase intraocular pressure [35].…”

Section: Preferred Antihypertensive Agentsmentioning

confidence: 99%