ABSTRACT
Clinicians frequently have to manage acute blood pressure (BP) reduction for a critically ill patient, without specific indications established by clinical trials; antihypertensive drugs are often administered based on pathophysiological considerations and/or according to individual clinical experience. The mechanisms leading to the acute elevation of BP in patients with hypertensive emergencies remain poorly understood. Hypertensive emergency is an acute increase in BP associated with new-onset or worsening target-organ damage, potentially life-threatening and requiring hospitalization and rapid BP control by the use of intravenous antihypertensive drugs. Hypertensive urgency is a rapid and severe increase in BP, with or without very mild symptoms suggesting acute organ damage. Among patients presenting in an office setting with a hypertensive urgency, a low percentage were referred to the emergency room. Treatment aspects of hypertensive emergencies and urgencies vary widely according to a patient's clinical conditions, and are largely based on experience rather than evidence.
