High blood pressure is a frequent finding in the emergency department. Its management depends on the presence of organ damage (renal, cardiac or neurological), which classifies the clinical condition as “hypertensive emergency”. The management of hypertensive emergency is based on an aggressive therapeutic approach to lower blood pressure depending on the nature of organ damage.
In cases of elevated blood pressure without organ damage the management consists of slowly lowering the blood pressure using oral medication.
This review aimed to elucidate the advances in management of elevated blood pressure in emergency department.
Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31:1281-357.
Omoyemi A, Robert L.R. Hypertensive Emergencies in the Emergency Department. Emerg Med Clin North Am 2015; 33:539-51.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation 2014; 129:399-410.
McNaughton CD, Self WH, Zhu Y, Janke AT, Storrow AB, Levy P. Incidence of Hypertension Related Emergency Department Visits in the United States, 2006 to 2012. Am J Cardiol 2015; 116:1717-23.
Pinna G, Pascale C, Fornengo P, Arras S, Piras C, Panzarasa P, et al. Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study. PLoS One 2014; 9:e93542.
Ault MJ, Ellrodt AG. Pathophysiological events leading to the end-organ effects of acute hypertension. Am J Emerg Med 1985; 3:10-5.
Michael M, Michael B, Eric G. Revisions to the Canadian Emergency Department Triage and Acuity Scale Implementation Guidelines. Can J Emerg Med 2004; 6:421-7
Morgenstern LB, Hemphill JC, Anderson C, Becker K, Broderick JP, Connolly ES, et al. Guidelines for the management of spontaneous intracerebral hemorrhage AHA/ASA guidelines. Stroke 2010; 41:2108-29.
Lisk D, Grotta J, Lamki L, Tran H, Taylor J, Molony D et al. Should hypertension be treated after acute stroke? A randomized controlled trial using single photon emission computed tomography. Arch Neurol 1993; 50:855-62.
Miller J, Kini H, Christpher L, Nowak R, Lewandowski P. Management of hypertension in stroke. Annals Emerg Med 2014; 64:249-55.
Anjan T, Ankur Sh, Rakesh K. Posterior reversible encephalopathy. J Obstet Anaesth Crit Care 2014; 4:59-63.
Linn FHH, Rinkel GJE, Algra A, Van Gijn J. Headache characteristics in subarachnoid haemorrhage and benign thunderclap headache. J Neurol Neurosurg Psychiatry 1998; 65:791-3.
Van Gijn J, Kerr R, Gabriel JE, Rinkel G. Subarachnoid haemorrhage. Lancet 2007; 369:306-18.
Varon J, Marik PE. The diagnosis and management of hypertensive crises. Chest 2000; 118:214-27.
Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, et al. 2013 ACCF/AHA Guideline for the Management of Heart Failure. A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013; 62:147-239.
Khan IA, Nair CK. Clinical, diagnostic and management perspectives of aortic dissection. Chest 2002; 122:311-28.
Xavier M, Paul E. What’s new with hypertensive crises. Intensive Care Med 2015; 41:127-30.
Frohlich ED. Target organ involvement in hypertension: a realistic promise of prevention and reversal. Med Clin North Am 2004; 88:1-9.
Blumenfeld JD, Laragh JH. Management of hypertensive crises: the scientific basis for treatment decisions. Am Heart J 2001; 14:1154-67.