Hypertensive crisis

Question 1

Definition of Hypertensive Crisis

Answer 1

Hypertensive crisis refers to a severe elevation in blood pressure that requires immediate medical attention. It is characterized by a systolic blood pressure (the top number) of 180 mm Hg or higher or a diastolic blood pressure (the bottom number) of 120 mm Hg or higher.

Question 2

Classification of Hypertensive Crisis

Answer 2

Hypertensive crises can be classified into two types:

Hypertensive Urgency: In this situation, blood pressure is severely elevated, but there is no evidence of acute organ damage. Urgent medical evaluation and prompt blood pressure reduction are still necessary.

Hypertensive Emergency: This is a more severe condition where blood pressure is extremely high and associated with acute organ damage. Target organ damage can involve the brain (hypertensive encephalopathy), heart (acute myocardial infarction or heart failure), kidneys (acute kidney injury), or other organs. Hypertensive emergencies require immediate medical intervention to lower blood pressure and prevent further complications.

Question 3

Treatment for hypertensive crisis

Answer 3

Treatment for hypertensive crisis typically involves hospitalization for close monitoring and intravenous medications to rapidly lower blood pressure. The choice of medication depends on the specific situation and associated complications. Some commonly used medications include:

Intravenous vasodilators: Medications like nitroglycerin, nitroprusside, or nicardipine are often administered to relax and dilate blood vessels, reducing blood pressure.

Beta-blockers: Drugs such as labetalol or esmolol may be used to block the effects of adrenaline, reducing heart rate and blood pressure.

Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs): These medications are generally avoided during acute hypertensive crisis due to the potential risk of reducing blood flow to organs.