Hypertensive Crisis

Document Type

Book Chapter

AKU Student

no

Publication (Name of Journal)

StatPearls [Internet]

Department

Medicine

Publisher

StatPearls Publishing

Abstract

Hypertensive crisis is a severe medical condition characterized by a rapid and marked blood pressure elevation, commonly defined as systolic pressure over 180 mm Hg or diastolic pressure exceeding 120 mm Hg, although these thresholds are not independently predictive of adverse outcomes. Etiologies include uncontrolled primary hypertension, secondary renal or endocrine disorders, and medication nonadherence. Risk factors encompass advanced age, obesity, chronic cardiovascular or renal disease, and prior hypertensive episodes. Abrupt rises in vascular resistance cause endothelial injury, impaired autoregulation, and organ ischemia.
Hypertensive crises are classified as either urgencies or emergencies. Urgencies involve severe blood pressure elevation without evidence of acute target-organ damage, whereas emergencies are associated with life-threatening organ injury requiring immediate intervention. Neurological manifestations may include headache, visual disturbances, and altered mental status. Cardiovascular signs can present as chest pain or heart failure. Renal abnormalities may include oliguria or hematuria.
Diagnosis requires blood pressure measurement and assessment for acute target-organ damage using laboratory studies, electrocardiography, and imaging. Management depends on classification: hypertensive emergencies require rapid intravenous antihypertensive therapy, while urgencies are treated with oral agents and close monitoring. Complications include stroke, myocardial infarction, acute renal failure, and death, emphasizing the necessity of timely recognition and intervention.
This activity for healthcare professionals is designed to sharpen learners' skills in evaluating and managing a hypertensive crisis. Participants will deepen their understanding of the condition's etiology, risk factors, pathophysiology, clinical presentation, and evidence-based diagnostic and therapeutic strategies. Improved competence will empower clinicians to collaborate with interprofessional teams caring for affected individuals.

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