ABSTRACT
DEFINITION ■ Hypertensive crisis-acute, severe increase in blood pressure,
with or without end-organ damage, that occurs in a setting in which rapid control is necessary: coronary artery disease, aortic dissection, bleeding intracranial aneurysm, postoperative state, or heart failure
CLASSIFICATION Hypertensive Emergency ■ Increased blood pressure to systolic pressure >210 mm Hg
and/or diastolic pressure >130 mm Hg causing symptoms of severe target-organ impairment: headache, papilledema and blurred vision, acute renal failure, acute coronary syndromes, pulmonary edema, encephalopathy, aortic dissection
Hypertensive Urgency ■ Sudden increase in blood pressure, with systolic pressure
>180 mm Hg and/or diastolic pressure ≥130 mm Hg, without overt evidence of end-organ damage but in a clinical setting in which it is urgent to prevent progression to hypertensive emergency
Malignant Hypertension ■ Hypertensive urgency characterized by rapidly progressive
vasospastic disorder with increased peripheral resistance; cerebral vessel dilatation; high plasma levels of renin, angiotensin, and aldosterone; generalized arteriolar fibrinoid necrosis; and target-organ damage
The causes of hypertensive crisis are listed in Table 1.
