Hypertensive Urgency vs Emergency

Question 1

Hypertensive Emergency

Answer 1

Blood pressure > 180/120 complicated by evidence of impending or progressive target organ dysfunction

Question 2

Hypertensive Urgency

Answer 2

180/120 with no evidence of end organ damage

Question 3

Physical assessment of HTN emergency

Answer 3

BP measurement
General appearance
Fundoscopy
Neck-palpate and auscultate carotids, thyroid
Heat: size, rhythm, sounds
Lungs: rales rhonci?
Abdomen:renal masses, bruits over aorta or renal arteries
Estremities: peripheral pulses, edema
Nuero assessment

Question 4

Treatment of HTN crisis-Emergency

Answer 4

Reduce BP by no more than 25% within minutes to 1 hour. If stable, then to 160/100-110 within the next 2-6 hours.
10% first hour and then 15% within 2-3 hours more.

Question 5

HTN Urgency

Answer 5

reduce no more than 25% in 24 hours. with oral therapy.

Question 6

Short acting Nifedipine is no longer acceptable

Answer 6

It can cause excessive falls in BP and can cause problems.