Hypertensive Crisis: An Emergent Condition-Treatment and Management Plans in Emergency Departments.

Abstract

Background: Hypertensive emergencies are characterized by a rapid and significant rise in blood pressure, often exceeding 180/110 mmHg, which can lead to acute organ damage and high morbidity rates. These emergencies require immediate medical intervention to prevent further complications, such as stroke, heart failure, and renal failure. The aim of this article is to provide an updated overview of hypertensive crises, focusing on the latest findings in assessment and management strategies within emergency departments (EDs).

Aim: The article aims to synthesize recent research on hypertensive emergencies, focusing on the epidemiology, risk factors, diagnostic evaluation, and treatment options available for emergency care providers. It also highlights existing knowledge gaps and offers insights into improving patient outcomes.

Methods: A comprehensive review of literature published between November 2008 and October 2023 was conducted using Medline, Embase, and Google Scholar, prioritizing randomized controlled trials (RCTs) and professional guidelines. The studies reviewed included both observational and interventional research relevant to hypertensive emergencies such as intracerebral hemorrhage, aortic dissection, and hypertensive encephalopathy.

Results: Hypertensive emergencies are rare, accounting for 0.6% of emergency department visits. Factors such as medication non-adherence, chronic conditions (e.g., heart failure, stroke), and socioeconomic determinants of health contribute to the occurrence of these crises. The key pathophysiological mechanisms include vascular damage, endothelial dysfunction, and autoregulatory dysfunction in organ systems. Effective management of these emergencies includes careful monitoring and controlled lowering of blood pressure, with an emphasis on organ protection.

Conclusion: Hypertensive emergencies require urgent and precise medical intervention to prevent severe organ damage. While there is a need for clearer definitions and more research, current management strategies focus on controlled blood pressure reduction and addressing the underlying causes. More research is needed to improve outcomes and minimize complications, particularly in high-risk populations.