980 results match your criteria Hypertensive Emergencies


[Comments on the guidelines (2018) of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) on the management of arterial hypertension].

Internist (Berl) 2019 Feb 15. Epub 2019 Feb 15.

Institut für Klinische Pharmakologie und Toxikologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, und Berlin Institute of Health, Charitéplatz 1, Berlin, 10117, Deutschland.

Arterial hypertension represents one of the most frequent chronic diseases that can lead to complications, such as stroke, dementia, heart attack, heart failure and renal failure. By 2025 the number of hypertensive patients will increase to approximately 1.6 billion people worldwide. Read More

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http://dx.doi.org/10.1007/s00108-019-0576-9DOI Listing
February 2019

Acute and Chronic Hypertension: What Clinicians Need to Know for Diagnosis and Management.

Crit Care Nurs Clin North Am 2019 Mar;31(1):97-108

PCFNP Concentration, LSU Health New Orleans School of Nursing, 1900 Gravier Street, New Orleans, LA 70112, USA.

Hypertension is the most common primary diagnosis in the United States. Multiple sequelae of disease states are attributable to hypertension. Minimal to modest improvements in blood pressure can result in improved cardiovascular-related health outcomes. Read More

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http://dx.doi.org/10.1016/j.cnc.2018.11.008DOI Listing
March 2019
1 Read

Incorporating selected non-communicable diseases into facility-based surveillance systems from a resource-limited setting in Africa.

BMC Public Health 2019 Feb 4;19(1):147. Epub 2019 Feb 4.

University of California San Diego, San Diego, USA.

Background: As Mozambique faces a double burden of diseases, with a rise of Non Communicable Diseases (NCD) superimposed to uncontrolled communicable diseases (CD), routine disease surveillance system does not include NCD. The objectives of our study were to i) upgrade of the current surveillance system by adapting the data collection tools to NCD; ii) describe the occurrence and profile of selected NCD using these data collection tools.

Methods: Workshops were implemented in a first referral urban hospital of Mozambique to train clinical staff, administrative workers and nurses on NCD surveillance, as well as select conditions to be prioritized. Read More

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https://bmcpublichealth.biomedcentral.com/articles/10.1186/s
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http://dx.doi.org/10.1186/s12889-019-6473-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6360799PMC
February 2019
3 Reads

Prevalence and risk factors for hypertensive crisis in a predominantly African American inner-city community.

Blood Press 2019 Jan 22:1-10. Epub 2019 Jan 22.

a Department of Emergency Medicine , Newark Beth Israel Medical Center , Newark , New Jersey , USA.

Purpose: A 3-year case control study was conducted to determine the prevalence of hypertensive crisis and its subtypes, hypertensive emergency and hypertensive urgency. The secondary objectives were to identify risk factors for hypertensive emergencies and to determine the odds of developing acute target organ damage among predominantly African American patients with a confirmed diagnosis of hypertension.

Materials And Methods: Using emergency department medical records, patients with a confirmed diagnosis of hypertension were identified. Read More

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https://www.tandfonline.com/doi/full/10.1080/08037051.2019.1
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http://dx.doi.org/10.1080/08037051.2019.1568183DOI Listing
January 2019
15 Reads

Biochemical markers as diagnostic/prognostic indicators for ischemic disease.

Afr Health Sci 2018 Jun;18(2):287-294

Department of Biochemistry, Faculty of science, King Abdulaziz University, Jeddah, Saudi Arabia.

Objective: The use of a biomarker was extremely useful in clinical emergencies such as stroke to aid in triage and early management of cases. The diagnostic accuracy of laboratory biomarkers is run to approve the identification of easy, cheap and fast tests associated with cerebral ischemia and intracranial hemorrhage. The present study was designed to screen serum enolase activity, activities of CK-BB, LDH and lipid profile in patients with ischemic or related diseases as good diagnostic/ prognostic indicator for ischemic diseases. Read More

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http://dx.doi.org/10.4314/ahs.v18i2.13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306977PMC
June 2018
1 Read

Hydralazine HCl rapidly disintegrating sublingual tablets: simple dosage form of higher bioavailability and enhanced clinical efficacy for potential rapid control on hypertensive preeclampsia.

Drug Des Devel Ther 2018 5;12:3753-3766. Epub 2018 Nov 5.

Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Minia University, Minia, Egypt.

Background: Hypertensive disorders are the most common complication in pregnancy which can even lead to maternal mortality. Hydralazine hydrochloride (HHC), a direct-acting vasodilator, is intravenously used as the first-line therapy in controlling hypertension in pregnancy (preeclampsia). It suffers poor oral bioavailability (26%-50%) due to first-pass metabolism. Read More

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http://dx.doi.org/10.2147/DDDT.S173326DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6225918PMC
November 2018
11 Reads

Strain analysis for the identification of hypertensive cardiac end-organ damage in the emergency department.

Crit Ultrasound J 2018 Nov 19;10(1):29. Epub 2018 Nov 19.

Department of Emergency Medicine, University of Illinois at Chicago, 808 S. Wood Street (MC 724), Chicago, IL, 60612, USA.

Hypertensive emergency is a life-threatening state. End-organ damage affecting the heart accounts for up to 52% of hypertensive emergencies commonly encountered in the emergency department. Recent evidence indicates that strain echocardiography with computerized speckle-tracking is more sensitive at identifying hypertension induced changes in the left ventricle (LV) mechanical function than traditional 2-D echocardiography. Read More

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http://dx.doi.org/10.1186/s13089-018-0110-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240555PMC
November 2018
1 Read

Hydralazine-associated antineutrophil cytoplasmic antibody vasculitis with pulmonary-renal syndrome.

BMJ Case Rep 2018 Nov 8;2018. Epub 2018 Nov 8.

Nephrology, Deaconess Health System, Evansville, Indiana, USA.

Hydralazine, a vasodilator, is commonly used as an adjunctive treatment for moderate to severe hypertension, heart failure and hypertensive emergencies in pregnancy. Hydralazine-induced lupus was first described in 1953. Clinical presentation ranges from arthralgia, myalgia, petechiae, or rash to single or multiorgan involvement. Read More

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http://casereports.bmj.com/lookup/doi/10.1136/bcr-2018-22716
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http://dx.doi.org/10.1136/bcr-2018-227161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6229221PMC
November 2018
7 Reads

Hypertensive emergencies in diabetic patients from predominantly African American urban communities.

Clin Exp Hypertens 2018 Oct 4:1-7. Epub 2018 Oct 4.

b Department of Emergency Medicine , Newark Beth Israel Medical Center , Newark , NJ , USA.

Aim: The aim of this study was to identify risk factors for hypertensive emergencies in diabetic patients presenting with severely elevated blood pressure.

Methods: Using electronic medical records, this study identified diabetic patients with hypertensive crisis who presented to the emergency department of Newark Beth Israel Medical Center, Newark, NJ from June 2013 to May 2016. Diabetic patients with hypertensive emergencies were compared with non-diabetic patients based on important demographic and clinical characteristics. Read More

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http://dx.doi.org/10.1080/10641963.2018.1516774DOI Listing
October 2018
11 Reads

[Hypertensive urgencies: Description of clinical characteristics, management, variables associated with re-entry and short-term prognosis].

Hipertens Riesgo Vasc 2018 Sep 20. Epub 2018 Sep 20.

Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Unidad de Hipertensión, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.

Objectives: To describe the characteristics of hypertensive urgencies at the emergency department, as well as the variables associated with early re-admission (<7 days) and re-admission at one month (<30 days).

Methods: We conducted a descriptive, retrospective study of all patients who were admitted to the emergency department of a third level hospital during 2013. Subsequently, a case-control analysis was performed to analyze the group of patients with readmission. Read More

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http://dx.doi.org/10.1016/j.hipert.2018.07.003DOI Listing
September 2018
20 Reads

Malignant Hypertension in Association with Low Estrogen Dose Oral Contraceptives: Case Report and Review of Literature.

Cureus 2018 Jul 13;10(7):e2978. Epub 2018 Jul 13.

Internal Medicine, Icahn School of Medicine at Mount Sinai/Queens Hospital Center, New York, USA.

Malignant hypertension (MH) has been described in association with high-dose (50 - 100 mcg) estrogen oral contraceptive pills (OCPs). Although the rise in blood pressure (BP) is usually mild, some women will have a more significant increase in BP, and hypertensive emergencies may very rarely occur. We present a 21-year-old Caucasian female with a past medical history of fibromyalgia and family history of hypertension (both grandparents) who was admitted with a three-day history of headache and blurring of vision in her left eye with a BP of 210/150. Read More

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https://www.cureus.com/articles/13098-malignant-hypertension
Publisher Site
http://dx.doi.org/10.7759/cureus.2978DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141051PMC
July 2018
5 Reads

ESC Council on hypertension position document on the management of hypertensive emergencies.

Eur Heart J Cardiovasc Pharmacother 2019 01;5(1):37-46

University College London (UCL) and UCL Hospitals, London, UK.

Hypertensive emergencies are those situations where very high blood pressure (BP) values are associated with acute organ damage, and therefore, require immediate, but careful, BP reduction. The type of acute organ damage is the principal determinant of: (i) the drug of choice, (ii) the target BP, and (iii) the timeframe in which BP should be lowered. Key target organs are the heart, retina, brain, kidneys, and large arteries. Read More

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http://dx.doi.org/10.1093/ehjcvp/pvy032DOI Listing
January 2019
57 Reads

Lesson of the month 2: Blunt abdominal trauma: atypical presentation of phaeochromocytoma.

Clin Med (Lond) 2018 Aug;18(4):345-347

Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

A 26-year-old man presented following blunt abdominal trauma to a regional major trauma centre for emergency embolisation of a retroperitoneal bleed from a presumed renal laceration. Imaging had also revealed a large right suprarenal mass. Embolisation resulted in a hypertensive crisis raising the suspicion of a metabolically active adrenal tumour. Read More

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http://dx.doi.org/10.7861/clinmedicine.18-4-345DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334037PMC
August 2018
7 Reads

Therapeutic Approach to Hypertension Urgencies and Emergencies During Acute Coronary Syndrome.

High Blood Press Cardiovasc Prev 2018 Sep 31;25(3):253-259. Epub 2018 Jul 31.

Hypertension Unit, Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, University of Rome Sapienza, Rome, Italy.

Uncontrolled hypertension is one of the most common determinant for the persistently high burden of cardiovascular (CV) disease, mostly including coronary artery disease (CAD) and hospital admissions due to acute coronary events. Markedly high blood pressure (BP) levels are also frequently observed during the acute phase of coronary syndromes (both ST-segment and non-ST-segment elevation myocardial infarction and unstable angina). In particular, a sustained raise of BP levels above 180/110 mmHg associated with acute cardiac organ damage, i. Read More

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http://dx.doi.org/10.1007/s40292-018-0275-yDOI Listing
September 2018
5 Reads

An assessment of critical care capacity in the Gambia.

J Crit Care 2018 Oct 22;47:245-253. Epub 2018 Jul 22.

University of Massachusetts Medical School, Worcester, MA, United States of America; Umass Memorial Medical Center, Worcester, MA, United States of America.

Purpose: Critical illnesses are a major cause of morbidity and mortality in The Gambia, yet national data on critical care capacity is lacking.

Materials And Methods: We surveyed eight of the eleven government-owned health facilities providing secondary and tertiary care in The Gambia's public health sector. At each hospital, a designated respondent completed a questionnaire reporting information on the presence of an intensive care unit, the number of critical care beds where available, monitoring equipment, and the ability to provide basic critical care services at their respective hospitals. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08839441183057
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http://dx.doi.org/10.1016/j.jcrc.2018.07.022DOI Listing
October 2018
4 Reads

The feasibility of task-sharing the identification, emergency treatment, and referral for women with pre-eclampsia by community health workers in India.

Reprod Health 2018 Jun 22;15(Suppl 1):101. Epub 2018 Jun 22.

KLE Academy of Higher Education and Research's, J N Medical College, Belagavi, Karnataka, India.

Background: Hypertensive disorders are the second highest direct obstetric cause of maternal death after haemorrhage, accounting for 14% of maternal deaths globally. Pregnancy hypertension contributes to maternal deaths, particularly in low- and middle-income countries, due to a scarcity of doctors providing evidence-based emergency obstetric care. Task-sharing some obstetric responsibilities may help to reduce the mortality rates. Read More

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http://dx.doi.org/10.1186/s12978-018-0532-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019995PMC
June 2018
19 Reads
1.620 Impact Factor

Definitions and Epidemiological Aspects of Hypertensive Urgencies and Emergencies.

High Blood Press Cardiovasc Prev 2018 Sep 18;25(3):241-244. Epub 2018 Jun 18.

Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Acute blood pressure (BP) elevation represents a frequent reason of concern for clinicians in everyday clinical practice. The terms "hypertensive emergencies" and "hypertensive urgencies" may be used in order to better define the so called "hypertensive crises". A hypertensive emergency may be defined as a condition characterized by an acute and severe elevation of blood pressure (BP) associated to a new onset or worsening organ damage (OD). Read More

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http://dx.doi.org/10.1007/s40292-018-0263-2DOI Listing
September 2018
5 Reads

Focused Update on Pharmacologic Management of Hypertensive Emergencies.

Curr Hypertens Rep 2018 Jun 8;20(7):56. Epub 2018 Jun 8.

University of Maryland School of Pharmacy, 20 N Pine Street, Baltimore, MD, 21201, USA.

Purpose Of Review: Hypertensive emergency is defined as a systolic blood pressure > 180 mmHg or a diastolic blood pressure > 120 mmHg with evidence of new or progressive end-organ damage. The purpose of this paper is to review advances in the treatment of hypertensive emergencies within the last 5 years.

Recent Findings: New literature and recommendations for managing hypertensive emergencies in the setting of pregnancy, stroke, and heart failure have been published. Read More

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http://dx.doi.org/10.1007/s11906-018-0854-2DOI Listing
June 2018
3 Reads

Sublingual nitroglycerin for early blood pressure control in hypertensive emergencies: observations from an emergency department clinical audit in Sri Lanka.

BMC Res Notes 2018 Jun 5;11(1):355. Epub 2018 Jun 5.

Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka.

Objective: Hypertensive emergencies are potentially life threatening and require prompt blood pressure control with intravenous agents. Preparation of intravenous infusions is time consuming. Usefulness of sublingual nitroglycerin in this setting is not known. Read More

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http://dx.doi.org/10.1186/s13104-018-3460-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5989332PMC
June 2018
3 Reads

Therapeutic Approach to Hypertensive Emergencies: Hemorrhagic Stroke.

High Blood Press Cardiovasc Prev 2018 Jun 4;25(2):191-195. Epub 2018 Jun 4.

Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Arterial hypertension represents the most important risk factor for ischemic and haemorrhagic stroke, and an acute hypertensive response is often observed in patients with intracranial haemorrhage (ICH). Available data indicate that the vast majority (> 70%) of patient with acute ICH have a systolic BP above 140 mmHg at the time of presentation in the ED; about 20% have SBP values above 180 mmHg. Severe BP elevation in the presence of ICH represents a hypertensive emergency, and worsening of clinical conditions is not infrequent in the first hours after admission; an aggressive early management is therefore required for these patients. Read More

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http://dx.doi.org/10.1007/s40292-018-0262-3DOI Listing
June 2018
2 Reads

World's First 24/7 Mobile Stroke Unit: Initial 6-Month Experience at Mercy Health in Toledo, Ohio.

Front Neurol 2018 17;9:283. Epub 2018 May 17.

Neuroscience Institute, Mercy Health-St. Vincent Medical Center, Toledo, OH, United States.

Background And Purpose: As the fourth mobile stroke unit (MSU) in the nation, and the first 24/7 unit worldwide, we review our initial experience with the Mercy Health MSU and institutional protocols implemented to facilitate rapid treatment of acute stroke patients and field triage for patients suffering other time-sensitive, acute neurologic emergencies in Lucas County, Ohio, and the greater Toledo metropolitan area.

Methods: Data was prospectively collected for all patients transported and treated by the MSU during the first 6 months of service. Data was abstracted from documentation of on-scene emergency medical services (EMS) personnel, critical care nurses, and onboard physicians, who participated through telemedicine. Read More

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http://dx.doi.org/10.3389/fneur.2018.00283DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5966532PMC
May 2018
8 Reads

Hypertension Update: Hypertensive Emergency and Asymptomatic Severe Hypertension.

Authors:
Anthony J Viera

FP Essent 2018 Jun;469:16-19

Department of Community and Family Medicine Duke University School of Medicine, Box 2914 DUMC, Durham, NC 27710.

Hypertensive emergency occurs when the blood pressure (BP) level is severely elevated (ie, higher than 180 mm Hg systolic or higher than 120 mm Hg diastolic) and acute organ damage is present. Patients with hypertensive emergencies are treated initially in the emergency department and then admitted to the intensive care unit. Management is directed at the specific situation, with the rate and extent of BP level lowering tailored to the type and extent of organ damage. Read More

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Therapeutic Approach to Hypertension Urgencies and Emergencies in the Emergency Room.

High Blood Press Cardiovasc Prev 2018 Jun 18;25(2):177-189. Epub 2018 May 18.

School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.

Hypertensive urgencies-emergencies are important and common events. They are defined as a severe elevation in BP, higher than 180/120 mmHg, associated or not with the evidence of new or worsening organ damage for emergencies and urgencies respectively. Anamnestic information, physical examination and instrumental evaluation determine the following management that could need oral (for urgencies) or intravenous (for emergencies) anti-hypertensives drugs. Read More

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http://dx.doi.org/10.1007/s40292-018-0261-4DOI Listing
June 2018
5 Reads

Time trends in characteristics, clinical course, and outcomes of 13,791 patients with acute heart failure.

Clin Res Cardiol 2018 Oct 4;107(10):897-913. Epub 2018 May 4.

The GREAT (Global REsearch on Acute conditions Team) Network, Rome, Italy.

Objectives: To analyse time trends in patient characteristics, clinical course, hospitalisation rate, and outcomes in acute heart failure along a 10-year period (2007-2016).

Methods: The EAHFE registry has prospectively collected 13,971 consecutive AHF patients diagnosed in 41 Spanish emergency departments (EDs) at five different time points (2007/2009/2011/2014/2016). Eighty patient-related variables and outcomes were described and statistically significant changes along time were evaluated. Read More

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http://dx.doi.org/10.1007/s00392-018-1261-zDOI Listing
October 2018
10 Reads

Release of endothelial microparticles in patients with arterial hypertension, hypertensive emergencies and catheter-related injury.

Atherosclerosis 2018 Jun 12;273:67-74. Epub 2018 Apr 12.

Division of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany; University of Surrey, Faculty of Health and Medical Sciences, Guildford, UK; Surrey and Sussex Healthcare NHS Trust, Redhill, UK. Electronic address:

Background And Aims: Circulating endothelial microparticles (EMPs) are increased in arterial hypertension. The role of physicomechanical factors that may induce EMP release in vivo is still unknown. We studied the relationship of EMPs and physicomechanical factors in stable arterial hypertension and hypertensive emergencies, and investigated the pattern of EMP release after mechanical endothelial injury. Read More

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http://dx.doi.org/10.1016/j.atherosclerosis.2018.04.012DOI Listing
June 2018
6 Reads

How an Elevated Creatinine Level Can Deter the Diagnosis of Acute Aortic Dissection.

Cureus 2018 Jan 12;10(1):e2057. Epub 2018 Jan 12.

Department of Combined Internal Medicine-Pediatrics, Hurley Medical Center, Michigan State University College of Human Medicine.

Acute aortic dissection (AAD) classically manifests with sudden, severe chest pain radiating to the back or abdomen, often described as ripping or tearing sensation. Considering its abrupt onset, the diagnosis requires a high index of suspicion prompting immediate imaging using computed tomography (CT) with contrast. However, the use of contrast is a relative contraindication in the patients with renal compromise and acute care physicians are often deterred from contrast use in these patients. Read More

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http://dx.doi.org/10.7759/cureus.2057DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5849348PMC
January 2018
10 Reads

Hypertensive crisis with 2 target organ impairment induced by glycyrrhizin: A case report.

Medicine (Baltimore) 2018 Mar;97(11):e0073

Department of Endocrinology and Metabolism.

Rationale: Glycyrrhizin is the main active component of licorice. Licorice and glycyrrhizin induced hypertension has been widely reported, yet licorice and glycyrrhizin induced hypertensive crisis has been rarely known.

Patient Concerns: The case of this report was a 47-year-old woman, who took 225 mg of glycyrrhizin daily for 3 years due to primary biliary cholangitis. Read More

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http://dx.doi.org/10.1097/MD.0000000000010073DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882392PMC
March 2018
9 Reads

[Hypertensive crisis and posterior reversible encephalopathy syndrome (PRES)].

Authors:
Olaf Eberhardt

Fortschr Neurol Psychiatr 2018 05 28;86(5):290-300. Epub 2018 Feb 28.

Klinikum Bogenhausen Klinik für Neurologie.

The urgency and intensity of therapeutic response to a hypertensive crisis are governed by the presence or absence of acute end-organ damage, which define hypertensive emergency and hypertensive urgency, respectively. In case of hypertensive urgency a slow and moderate lowering of blood pressure by oral antihypertensive agents seems adequate, while the approach to hypertensive emergency has to be tailored to the specific type of organ failure. Optimal blood pressure management in the context of neurovascular emergencies is made difficult by contradictory data from observational and interventional studies. Read More

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http://dx.doi.org/10.1055/s-0043-122600DOI Listing
May 2018
7 Reads

Acute blood pressure elevation: Therapeutic approach.

Pharmacol Res 2018 04 23;130:180-190. Epub 2018 Feb 23.

Department of Clinical and Experimental Sciences University of Brescia, 2a medicina Spedali Civili, Brescia, 25100, Italy. Electronic address:

International guidelines have suggested to avoid the term "hypertensive crisis" for the description of an acute and severe increase in blood pressure (BP) and to consider the definition of 'hypertensive emergencies' or 'hypertensive urgencies'. These two clinical presentations are characterized by the presence of high BP values but imply a different diagnostic and therapeutic approach. Hypertension awareness, treatment and control are slightly increased in the last years mostly in the United States and in some European nations. Read More

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http://dx.doi.org/10.1016/j.phrs.2018.02.026DOI Listing
April 2018
3 Reads

New Developments in Hypertensive Encephalopathy.

Curr Hypertens Rep 2018 02 26;20(2):13. Epub 2018 Feb 26.

Department of Emergency Medicine, Wayne State University, Detroit, MI, USA.

Purpose Of Review: This review summarizes the latest science on hypertensive encephalopathy and posterior reversible encephalopathy syndrome (PRES). We review the epidemiology and pathophysiology of these overlapping syndromes and discuss best practices for diagnosis and management.

Recent Findings: Diagnosis of hypertensive encephalopathy largely relies on exclusion of other neurological emergencies. Read More

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http://dx.doi.org/10.1007/s11906-018-0813-yDOI Listing
February 2018
9 Reads

Sympathomimetic Toxidromes and Other Pharmacological Causes of Acute Hypertension.

Curr Hypertens Rep 2018 02 24;20(1). Epub 2018 Feb 24.

Michigan Regional Poison Control Center, Wayne State University School of Medicine, Detroit, MI, USA.

Purpose Of Review: Acute drug-induced hypertension, sympathomimetic toxicity, and other hyperadrenergic states can be caused by both xenobiotic toxicity and withdrawal. This manuscript is a selective review of the recent literature regarding pharmacologic causes of hypertensive emergencies and other hyperadrenergic states.

Recent Findings: We will discuss designer stimulants, alpha and baclofen agonist withdrawal, and the clinical entity known as posterior reversible encephalopathy syndrome (PRES). Read More

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http://dx.doi.org/10.1007/s11906-018-0807-9DOI Listing
February 2018
9 Reads

Beyond signal functions in global obstetric care: Using a clinical cascade to measure emergency obstetric readiness.

PLoS One 2018 23;13(2):e0184252. Epub 2018 Feb 23.

University of California-San Francisco School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco, California, United States of America.

Background: Globally, the rate of reduction in delivery-associated maternal and perinatal mortality has been slow compared to improvements in post-delivery mortality in children under five. Improving clinical readiness for basic obstetric emergencies is crucial for reducing facility-based maternal deaths. Emergency readiness is commonly assessed using tracers derived from the maternal signal functions model. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184252PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825011PMC
March 2018
7 Reads

An experimental model for hypertensive crises emergencies: Long-term high-fat diet followed by acute vasoconstriction stress on spontaneously hypertensive rats.

Exp Biol Med (Maywood) 2018 03 14;243(5):481-495. Epub 2018 Feb 14.

1 Guangdong Engineering and Technology Research Center for Quality and Efficacy Re-evaluation of Post-marketed TCM, Guangdong Key Laboratory of Plant Resources, School of Life Sciences, Sun Yat-sen University, Guangzhou 510275, P.R. China.

Currently, the prevention and treatment of hypertensive crises especially when it occurs with serious adverse outcomes have led to worldwide controversy. Despite of clinical possibilities of multiple agents, clinical failures still occur frequently. Therefore, early evaluations and observations of different therapies on appropriate animals should be emphasized. Read More

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http://dx.doi.org/10.1177/1535370218759270DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5882032PMC
March 2018
15 Reads

Clinical features and outcomes of patients with type 2 myocardial infarction: Insights from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial.

Am Heart J 2018 02 16;196:28-35. Epub 2017 Oct 16.

Duke Clinical Research Institute, Durham, NC. Electronic address:

Background: Type 2 myocardial infarction (MI) is characterized by an imbalance between myocardial blood supply and demand, leading to myocardial ischemia without coronary plaque rupture, but its diagnosis is challenging.

Methods: In the TRACER trial, patients with non-ST-segment elevation acute coronary syndromes were included. We aimed to describe provoking factors, cardiac biomarker profiles, treatment patterns, and clinical outcomes of patients with type 2 MIs. Read More

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http://dx.doi.org/10.1016/j.ahj.2017.10.007DOI Listing
February 2018
19 Reads

"Near-Miss" Obstetric events and maternal mortality in a Tertiary Care Hospital.

Indian J Public Health 2017 Oct-Dec;61(4):305-308

Final Year Resident, Department of Urology, SVIMS, Tirupati, Andhra Pradesh, India.

Obstetric near-miss or severe acute maternal morbidity is gaining interest internationally as a new indicator of the quality of obstetric care. This is a retrospective study conducted using "The WHO Near-Miss Approach" to provide insight into obstetric emergencies, near-miss cases, and maternal deaths in our hospital. The maternal near-miss ratio was 8. Read More

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http://dx.doi.org/10.4103/ijph.IJPH_268_16DOI Listing
December 2017
2 Reads

Diagnostic and therapeutic approach to the hypertensive crisis.

Med Clin (Barc) 2018 Apr 24;150(8):317-322. Epub 2017 Nov 24.

Servicio de Medicina Interna, Unidad de riesgo cardiovascular, Hospital universitario Quirón Dexeus, Barcelona, España. Electronic address:

High blood pressure is a problem with elevated prevalence in the world population. The acute forms of presentation are "hypertensive crises," which represent a frequent cause for emergency room and primary care consultations. Hypertensive crises are divided into hypertensive emergencies and hypertensive urgencies, depending on whether or not there is acute damage to the target organ, respectively. Read More

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http://dx.doi.org/10.1016/j.medcli.2017.09.027DOI Listing
April 2018
11 Reads

Cardiovascular Emergencies in Pregnancy.

Cardiol Clin 2018 Feb;36(1):171-181

Department of Internal Medicine, Division of Cardiovascular Medicine, University of Maryland School of Medicine, 110 South Paca Street, 7th Floor, Baltimore, MD 21201, USA. Electronic address:

Heart disease in pregnancy may manifest as acute coronary syndromes, decompensated valvular disease, and acute heart failure. These disease processes may represent progression of preexisting disease versus newly developed disease resulting from the physiologic changes of pregnancy. Early recognition of clinical presentations, judicious use of diagnostic studies, and multidisciplinary management of patient and fetal considerations can lead to optimal outcomes in this unique patient subset. Read More

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http://dx.doi.org/10.1016/j.ccl.2017.09.006DOI Listing
February 2018
10 Reads

Impact of in-hospital blood pressure variability on cardiovascular outcomes in patients with acute coronary syndrome.

J Clin Hypertens (Greenwich) 2017 Dec 5;19(12):1252-1259. Epub 2017 Nov 5.

Department of Cardiology, Faculty of Medicine, Assiut University, Assiut, Egypt.

To evaluate the impact of blood pressure variability (BPV) on cardiovascular outcomes in patients with acute coronary syndrome, short-term BPV was estimated by using weighted standard deviation of 24-hour ambulatory blood pressure monitoring readings. The primary outcome was in-hospital major adverse cardiac events (MACE). Overall, 200 patients (mean age, 58. Read More

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http://doi.wiley.com/10.1111/jch.13107
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http://dx.doi.org/10.1111/jch.13107DOI Listing
December 2017
9 Reads

Like the Eye of the Tiger: Inpatient Psychiatric Facility Exclusionary Criteria and Its "Knockout" of the Emergency Psychiatric Patient.

J Emerg Trauma Shock 2017 Oct-Dec;10(4):189-193

Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, Texas, USA.

Context: Over 6% of all emergency department (ED) visits in the United States involve primary mental health or behavioral issues. The patients are stabilized in the ED but frequently require admission to an inpatient psychiatric unit or institution for longer term treatment and management. To facilitate this process, an emergency physician (EP) must first "medically clear" the patient as stable for transfer. Read More

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http://www.onlinejets.org/text.asp?2017/10/4/189/216523
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http://dx.doi.org/10.4103/JETS.JETS_126_16DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663137PMC
November 2017
6 Reads

Postpartum Headache.

Adv Emerg Nurs J 2017 Oct/Dec;39(4):258-265

Pacific Lutheran University School of Nursing, Tacoma, Washington. Dr Richardson is a retired Army Nurse Corps officer.

Approximately 40% of all women report experiencing headaches during the postpartum period, regardless of a previous headache history. This case narrative describes the clinical case of a 22-year-old woman who presented for the evaluation of an intractable headache for 2½ weeks. It demonstrates the inherent difficulty in diagnosing patients not presenting with "textbook" symptoms and highlights the fact that signs and symptoms of eclampsia/preeclampsia, such as elevated blood pressure, may fall below the threshold for hypertensive emergencies and not be considered in the differential. Read More

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http://dx.doi.org/10.1097/TME.0000000000000162DOI Listing
June 2018
9 Reads

Systemic hypertension and non-cardiac surgery.

Authors:
Satyajeet Misra

Indian J Anaesth 2017 Sep;61(9):697-704

Department of Anaesthesiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.

Primary systemic hypertension affects 10%-25% of individuals presenting for surgery and anaesthesia and constitutes an important cause of cancellation of elective surgeries. Much of the fear stems from the fact that hypertension may lead to adverse perioperative outcomes. Although long-standing hypertension increases the risk of stroke, renal dysfunction or major adverse cardiovascular events, the same is usually not seen in the perioperative period if blood pressure is <180/110 mmHg and this has been the overriding theme in the recent guidelines on perioperative blood pressure management. Read More

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http://dx.doi.org/10.4103/ija.IJA_377_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613594PMC
September 2017
40 Reads

[Hypertensive emergencies].

Authors:
Gerd Bönner

Dtsch Med Wochenschr 2017 Sep 22;142(19):1437-1445. Epub 2017 Sep 22.

Hypertensive urgency and hypertensive emergency are associated with sudden, massive rise in blood pressure. An acute increase in blood pressure to values above 180/120 mmHg is considered critical. If not treated in time, it can quickly enter a life-threatening hypertensive emergency. Read More

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http://dx.doi.org/10.1055/s-0043-105516DOI Listing
September 2017
3 Reads

The CRASH report: emergency management dilemmas facing acute physicians in patients with pulmonary arterial hypertension.

Thorax 2017 11 12;72(11):1035-1045. Epub 2017 Sep 12.

National Pulmonary Hypertension Service, Royal Brompton Hospital, London, UK.

Treatment of acute emergencies in patients with pulmonary arterial hypertension (PAH) can be challenging. In the UK and Ireland, management of adult patients with PAH is centred in eight nationally designated pulmonary hypertension (PH) centres. However, many patients live far from these centres and physicians in local hospitals are often required to manage PAH emergencies. Read More

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http://dx.doi.org/10.1136/thoraxjnl-2016-209725DOI Listing
November 2017
52 Reads

Appropriateness of Bolus Antihypertensive Therapy for Elevated Blood Pressure in the Emergency Department.

West J Emerg Med 2017 Aug 11;18(5):957-962. Epub 2017 Jul 11.

Wayne State University, Department of Emergency Medicine, Detroit, Michigan.

Introduction: While moderate to severely elevated blood pressure (BP) is present in nearly half of all emergency department (ED) patients, the incidence of true hypertensive emergencies in ED patients is low. Administration of bolus intravenous (IV) antihypertensive treatment to lower BP in patients without a true hypertensive emergency is a wasteful practice that is discouraged by hypertension experts; however, anecdotal evidence suggests this occurs with relatively high frequency. Accordingly, we sought to assess the frequency of inappropriate IV antihypertensive treatment in ED patients with elevated BP absent a hypertensive emergency. Read More

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http://dx.doi.org/10.5811/westjem.2017.5.33410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576634PMC
August 2017
10 Reads

Hydralazine vs nifedipine for acute hypertensive emergency in pregnancy: a randomized controlled trial.

Am J Obstet Gynecol 2017 12 1;217(6):687.e1-687.e6. Epub 2017 Sep 1.

Dr Rajendra Prasad Government Medical College, Tanda (HP), India.

Background: There is a paucity of good quality evidence regarding the best therapeutic option for acute control of blood pressure during acute hypertensive emergency of pregnancy.

Objective: We sought to compare the efficacy of intravenously administered hydralazine and oral nifedipine for acute blood pressure control in acute hypertensive emergency of pregnancy.

Study Design: In this double-blind, randomized, controlled trial, pregnant women (≥24 weeks period of gestation) with sustained increase in systolic blood pressure of ≥160 mm Hg or diastolic blood pressure of ≥110 mm Hg were randomized to receive intravenous hydralazine injection in doses of 5, 10, 10, and 10 mg and a placebo tablet or oral nifedipine (10 mg tablet up to 4 doses) and intravenous saline injection every 20 minutes until the target blood pressure of 150 mm Hg systolic and ≤100 mm Hg diastolic was achieved. Read More

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http://www.ajog.org/article/S0002937817309651/pdf
Web Search
https://www.researchgate.net/publication/257534132_Oral_Nife
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https://linkinghub.elsevier.com/retrieve/pii/S00029378173096
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http://dx.doi.org/10.1016/j.ajog.2017.08.018DOI Listing
December 2017
36 Reads

Hospital and out-of-hospital mortality in 670 hypertensive emergencies and urgencies.

J Clin Hypertens (Greenwich) 2017 Nov 3;19(11):1137-1142. Epub 2017 Sep 3.

Unité d'Hypertension Artérielle, Assistance Publique Hôpitaux de Marseille - Hôpital de la Timone, Marseille, France.

Long-term mortality in patients with acute severe hypertension is unclear. The authors aimed to compare short-term (hospital) and long-term (12 months) mortality in these patients. A total of 670 adults presenting for acute severe hypertension between January 1, 2015, and December 31, 2015, were included. Read More

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http://doi.wiley.com/10.1111/jch.13083
Publisher Site
http://dx.doi.org/10.1111/jch.13083DOI Listing
November 2017
20 Reads

A Prospective, Observational Study to Determine the Prevalence and Clinical Profile of Patients of Hypertensive Crisis in a Tertiary Care Hospital.

J Assoc Physicians India 2017 Jun;65(6):14-21

Ex Postgraduate Student, Department of Medicine, Seth G. S. Medical College and K.E.M. Hospital, Parel, Mumbai.

Background: Hypertension can present in crisis form as 'hypertensive urgency'(HU) or as 'hypertensive emergency' (HE). Both the conditions are associated with significant morbidity and mortality.

Aim: To evaluate the clinical characteristics, course of illness, end-organ damage and survival outcome in patients with hypertensive crisis. Read More

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June 2017
5 Reads

Evaluation of the safety and efficacy of metoprolol infusion for children and adolescents with hypertensive crises: a retrospective case series.

Pediatr Nephrol 2017 Nov 21;32(11):2107-2113. Epub 2017 Jul 21.

Jordan University of Science and Technology, Irbid, Irbid, Jordan.

Background: Acute severe hypertension occurs infrequently in pediatric patients and, consequently, data on the efficacy and safety of most antihypertensive agents, as well as the adverse events associated with these agents, are very limited in this population. In this case series, we evaluated the use of metoprolol infusion in children with hypertensive emergencies.

Methods: The study population comprised children younger than 18 years who had been admitted to the pediatric intensive care unit at King Abdullah University Hospital with blood pressure above the 99th percentile for age, height, and sex and who were symptomatic at the time of presentation. Read More

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http://dx.doi.org/10.1007/s00467-017-3720-6DOI Listing
November 2017
4 Reads