Medium urgency
Very commonModerately severe
Acute elevation of blood pressure that can cause alterations in different organs of the human body if not controlled early. A hypertensive crisis is considered to be a hypertensive crisis if the systolic blood pressure (SBP) or maximum blood pressure is higher than 180 mmHg and/or the diastolic blood pressure (DBP) or minimum blood pressure is higher than 120 mmHg.
It usually occurs in people diagnosed with hypertension, and the most frequent causes are discontinuation of antihypertensive treatment, drug abuse, heart failure, angina pectoris and cerebral infarction.
It manifests with headache, nosebleeds, chest pain, arrhythmias, shortness of breath, agitation, neurological disturbances, vertigo, tingling, dizziness, and/or vomiting.
It is a clinical diagnosis, through interrogation and physical examination with taking of vital signs. Complementary tests will be carried out to detect organ alterations.
It is a medical emergency that must be treated without delay with fast-acting antihypertensives. If known, the triggering cause should be treated to avoid recurrence.
- William J Elliott, Joseph Varon. Evaluation and treatment of hypertensive emergencies in adults. UpToDate, Aug 16, 2016.
- Mayer SA, Kurtz P, Wyman A, et al. Clinical practices, complications, and mortality in neurological patients with acute severe hypertension: the Studying the Treatment of Acute hyperTension registry. Crit Care Med 2011; 39:2330.
- Johnson W, Nguyen ML, Patel R. Hypertension crisis in the emergency department. Cardiol Clin 2012; 30:533.
- Kaplan NM, Victor RG. Chapter 8: Hypertensive Crises. In: Kaplan's Clinical Hypertension, 10th Ed, Lippincott, Williams & Wilkins, Philadelphia 2010. p.274.
- Theodore A. Kotchen. Vasculopatía hipertensiva. Harrison. Principios de Medicina Interna, 19e. Capítulo 298.
Dr. Oscar Garcia-Esquirol
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