Acute blood pressure elevation: Therapeutic approach

Abstract

International guidelines have suggested to avoid the term "hypertensive crisis" for the description of an acute and severe increase in blood pressure (BP) and to consider the definition of 'hypertensive emergencies' or 'hypertensive urgencies'. These two clinical presentations are characterized by the presence of high BP values but imply a different diagnostic and therapeutic approach. Hypertension awareness, treatment and control are slightly increased in the last years mostly in the United States and in some European nations. Nevertheless the prevalence of hypertensive emergencies is still high and remains associated to a higher mortality. International Guidelines have also given some recommendations regarding the target BP during treatment and the use of antihypertensive drugs in hypertensive emergencies, although the adherence to these indications is frequently suboptimal. The present paper is aimed to update the currently available data on the treatment of hypertensive emergencies.

Keywords: ACE-inhibitors; Acute coronary syndrome; Acute pulmonary edema; Calcium-antagonists; Diuretics; Hypertension; Hypertensive emergencies; Hypertensive urgencies; Labetalol; Nitrates; Stroke; Urapidil.