1,112 results match your criteria Hypertensive Emergencies

The Management of Hypertensive Emergencies-Is There a "Magical" Prescription for All?

J Clin Med 2022 May 31;11(11). Epub 2022 May 31.

Department of Cardiology, Colentina Hospital, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.

Hypertensive emergencies (HE) represent high cardiovascular risk situations defined by a severe increase in blood pressure (BP) associated with acute, hypertension mediated organ damage (A-HMOD) to the heart, brain, retina, kidneys, and large arteries. Blood pressure values alone do not accurately predict the presence of HE; therefore, the search for A-HMOD should be the first step in the management of acute severe hypertension. A rapid therapeutic intervention is mandatory in order to limit and promote regression of end-organ damage, minimize the risk of complications, and improve patient outcomes. Read More

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Differences in Diagnosis and Management of Hypertensive Urgencies and Emergencies According to Italian Doctors from Different Departments Who Deal With Acute Increase in Blood Pressure-Data from Gear (Gestione Dell'emergenza e Urgenza in ARea Critica) Study.

J Clin Med 2022 May 25;11(11). Epub 2022 May 25.

Internal Medicine, University of Brescia-ASST Spedali Civili di Brescia, 25121 Brescia, Italy.

Background: Diagnosis and treatment of hypertension emergency (HE) and urgency (HU) may vary according to the physicians involved and the setting of the treatment. The aim of this study was to investigate differences in management of HE and HU according to the work setting of the physicians.

Methods: The young investigators of the Italian Society of Hypertension developed a 23-item questionnaire spread by email invitation to the members of Italian Scientific societies involved in the field of emergency medicine and hypertension. Read More

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Enhancing adherence and management in patients with hypertension: Impact of form and frequency of knowledge intervention.

Indian Heart J 2022 Jun 3. Epub 2022 Jun 3.

Centre for Health Psychology, School of Medical Sciences, University of Hyderabad, Central University PO, Prof. C R Rao Road, Gachibowli, Hyderabad, 500046, Telangana, India. Electronic address:

Background: The alarming rise in prevalence of hypertension warrants psychosocial methods supplementing pharmacotherapy for better management and prevention of cardiac emergencies. The objective of the study was to assess the differential impact of the form and frequency of knowledge intervention on management of primary hypertension.

Materials And Method: The study was conducted on 256 hypertensive patients recruited through purposive sampling at health centers in Hyderabad, India. Read More

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Comparative efficacy of antihypertensive drugs in dogs: a systematic review.

Top Companion Anim Med 2022 May 28:100674. Epub 2022 May 28.

Department of Internal Medicine, College of Veterinary Medicine, Chonnam National University, Gwangju 61168, Korea; BK21 project team, College of Veterinary Medicine, Chonnam National University, Gwangju 61168, Korea. Electronic address:

Systemic arterial hypertension is a health condition causing target organ damage (TOD) in dogs. Early and effective treatment is essential to prevent hypertensive emergencies and to reduce the risk of TOD. This study investigated the diseases underlying hypertension and compared the short-term efficacy of antihypertensive drugs in dogs. Read More

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Blood Pressure Increase following COVID-19 Vaccination: A Systematic Overview and Meta-Analysis.

J Cardiovasc Dev Dis 2022 May 9;9(5). Epub 2022 May 9.

Fondazione Umbra Cuore e Ipertensione-ONLUS and Division of Cardiology, Hospital S. Maria della Misericordia, 06100 Perugia, Italy.

Coronavirus disease 2019 (COVID-19) vaccines proved a strong clinical efficacy against symptomatic or moderate/severe COVID-19 and are considered the most promising approach for curbing the pandemic. However, some questions regarding the safety of COVID-19 vaccines have been recently raised. Among adverse events to vaccines and despite a lack of signal during phase III clinical trials, an increase in blood pressure (BP) after COVID-19 vaccination has been reported as a potential adverse reaction. Read More

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How inequity threatens the lives of pregnant women: barriers to accessing health services during an incomplete miscarriage in rural southern Mexico.

BMJ Case Rep 2022 May 23;15(5). Epub 2022 May 23.

Programa de Salud Sexual y Reproductiva, Partners In Health México/Compañeros En Salud, Ángel Albino Corzo, Chiapas, México.

Globally, obstetric emergencies majorly account for maternal morbidity and mortality. Guerrero, Oaxaca and Chiapas accounted for more than 13% of maternal deaths in the country in 2021. Obstetric haemorrhage was the leading cause of maternal death after COVID-19 infection and hypertensive disorders. Read More

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Management of Hypertensive Crises in Children: A Review of the Recent Literature.

Front Pediatr 2022 15;10:880678. Epub 2022 Apr 15.

Paediatric Nephrology Unit, Department of Womens's and Children's Health, University Hospital of Padua, Padua, Italy.

Hypertensive emergency is a life-threatening condition associated with severe hypertension and organ damage, such as neurological, renal or cardiac dysfunction. The most recent guidelines on pediatric hypertension, the 2016 European guidelines and the 2017 American guidelines, provide recommendations on the management of hypertensive emergencies, however in pediatric age robust literature is lacking and the available evidence often derives from studies conducted in adults. We reviewed PubMed and Cochrane Library from January 2017 to July 2021, using the following search terms: "hypertension" AND "treatment" AND ("emergency" OR "urgency") to identify the studies. Read More

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SUPPLEMENT ARTICLE: A Novel Drug Delivery Method: Retrometabolic Drug Design.

J Drugs Dermatol 2022 Apr;21(4):s5-s10

Soft drugs, a class of retrometabolic drug design, contain a metabolically sensitive moiety that promotes rapid metabolism to inactive metabolites after exerting activity at its target site. The goal of soft drugs is to reduce systemic toxicity while enhancing local efficacy. Soft drugs have been approved for use in multiple medical specialties, such as the soft corticosteroid loteprednol etabonate for treatment of inflammatory ophthalmic disorders and soft beta-blocker derivatives for treatment of hypertensive emergencies in cardiology. Read More

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Primary Causes of Hypertensive Crisis.

Crit Care Clin 2022 Apr;38(2):375-391

Department of Pediatrics, Medical College of Wisconsin, 999 North 92nd Street, Suite C510, Milwaukee, WI 53226, USA.

Hypertensive crisis, especially in children, is a rare condition and is defined as a sudden and abrupt elevation in blood pressure that poses a threat of rapid onset of end-organ damage. Symptomatic hypertension requires urgent and thorough evaluation and management. In most patients with hypertensive crisis, a specific cause can be found with targeted investigation. Read More

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Posterior reversible encephalopathy syndrome - A pathology that should not be overlooked in the era of COVID-19.

Am J Emerg Med 2022 Jun 13;56:393.e5-393.e8. Epub 2022 Mar 13.

Neurology Department, University Emergency Hospital Bucharest, Splaiul Independentei, number 169, district 5, Bucharest ZIP code: 050098, Romania.

Background And Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) that causes Coronavirus Disease 2019 (COVID-19) may determine a series of neurological complications directly, by invasion of the nervous system or indirectly, secondary to systemic organ failure. Posterior reversible encephalopathy syndrome (PRES) represents a clinical and radiological neurological entity involving predominantly the occipital lobes. PRES was observed in patients receiving cytotoxic drugs, patients suffering from infectious diseases and sepsis, hypertensive emergencies and eclampsia, renal or autoimmune diseases. Read More

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[Internal medical emergencies in the pregnant patient : Peripartum sepsis, metabolic derailment, endocrinological emergencies and pulmonary edema].

Med Klin Intensivmed Notfmed 2022 Apr;117(3):239-252

Klinik für Anästhesiologie und Intensivmedizin, Klinikum Neumarkt i.d.OPf., Neumarkt i.d.OPf., Deutschland.

Peripartum emergencies that require intensive medical care represent a major challenge for the interdisciplinary treatment team. Due to physiological changes in pregnant women symptoms can be masked and the initiation of treatment is delayed. Peripartum sepsis has a relatively high incidence. Read More

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Risk factors for seizures in the vigorous term neonate: A population-based register study of singleton births in Sweden.

PLoS One 2022 17;17(2):e0264117. Epub 2022 Feb 17.

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Background: Neonatal seizures have been associated with increased mortality and impaired neurodevelopment and, knowledge about risk factors may be useful for prevention. Clear associations have been established between labor-related risk factors and seizures in asphyxiated neonates. However, there is limited information about why some vigorous term-born infants experience seizures. Read More

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February 2022

Guar gum based oral films for hypertensive urgencies.

Nat Prod Res 2022 Feb 15:1-4. Epub 2022 Feb 15.

Centre for Excellence in Nano bio-Translational Research (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, Tiruchirappalli, Tamil Nadu, India.

Guar gum (GG) is a natural film forming biopolymer used as a drug delivery media for Telmisartan (TS). TS is a poorly water-soluble anti-hypertensive agent with low bioavailability.The present work has been hypothesized by converting TS into nanocrystals by high shear homogenisation to enhance the solubility thereby the bioavailability is expected to get enhanced. Read More

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February 2022

Complement Blockade Is a Promising Therapeutic Approach in a Subset of Critically Ill Adult Patients with Complement-Mediated Hemolytic Uremic Syndromes.

J Clin Med 2022 Feb 1;11(3). Epub 2022 Feb 1.

CHU Bordeaux, Internal Medicine Department, F-33000 Bordeaux, France.

Thrombotic microangiopathy (TMA) gathers consumptive thrombocytopenia, mechanical haemolytic anemia, and organ damage. Hemolytic uremic syndromes (HUS) are historically classified as primary or secondary to another disease once thrombotic thrombocytopenic purpura (TTP), Shiga-toxin HUS, and cobalamin C-related HUS have been ruled out. Complement genetics studies reinforced the link between complement dysregulation and primary HUS, contributing to reclassifying some pregnancy- and/or post-partum-associated HUS and to revealing complement involvement in severe and/or refractory hypertensive emergencies. Read More

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February 2022

[High blood pressure in hospital: should it be treated?]

Rev Med Suisse 2022 Feb;18(768):229-234

Service de médecine interne générale, Centre hospitalier du Valais Romand, Hôpital du Valais, Hôpital de Sion, 1951 Sion.

Uncontrolled blood pressure is a problem frequently encountered in hospital. Health workers may be inclined to initiate or increase hypertensive treatment to decrease blood pressure. However, studies have shown that in the absence of hypertensive emergency, there is no indication to treat hypertension in hospitalized patients. Read More

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February 2022

Rationale for the Concept of Impending Hypertension-Mediated Organ Damage.

Curr Vasc Pharmacol 2022 ;20(2):127-133

Faculty of Medicine, University of Nis, Serbia.

Background: The number of patients with hypertension urgencies (HTN-Us) and emergencies (HTN-Es) in the emergency department is relatively constant despite improved detection, awareness and control of arterial hypertension.

Objective: This study analyses the precision of the often-used definition of HTN-E, particularly the phrase 'with the evidence of impending or progressive hypertension-mediated organ damage (HMOD)'. We then provide a rationale for the concept of impending HMOD. Read More

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January 2022

Nicardipine versus nitroglycerin for hypertensive acute heart failure syndrome: a single-center observational study.

J Rural Med 2022 Jan 12;17(1):33-39. Epub 2022 Jan 12.

Department of Emergency and Critical Care Medicine, University of Miyazaki Hospital, Japan.

Nitroglycerin is a first-line treatment for hypertensive acute heart failure syndrome (AHFS). However, nicardipine is frequently used to treat hypertensive emergencies, including AHFS. In this study, we compared the effectiveness of nicardipine and nitroglycerin in patients with hypertensive AHFS. Read More

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January 2022

[Prevalence of high blood pressure in hospitalized patients. A cross-sectional study].

Medicina (B Aires) 2021 ;81(6):1002-1006

Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.

Hypertension (HTN) is a prevalent disease. A 30% of the population is unaware of having HTN and 65% of patients with HTN have a poor control. There is no standardized way to diagnose HTN in the inpatient setting. Read More

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December 2021

Sex Differences in Long-Term Mortality of Patients with Hypertensive Crisis Visiting the Emergency Department.

J Womens Health (Larchmt) 2021 Dec 2. Epub 2021 Dec 2.

Division of Cardiology, Department of Internal Medicine, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Republic of Korea.

There are limited data on sex difference in patients with hypertensive crisis. We investigated sex differences in characteristics and long-term mortality in patients with hypertensive crisis visiting the emergency department (ED). This cross-sectional study at a tertiary referral center included patients ≥18 years of age who were admitted to the ED between 2016 and 2019 with hypertensive crisis, defined as systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg. Read More

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December 2021

Modern Management of Hypertensive Emergencies.

High Blood Press Cardiovasc Prev 2022 Jan 23;29(1):33-40. Epub 2021 Nov 23.

Department of Medicine-DIMED, University of Padua, Padua, Italy.

Acute increases of blood pressure values are common causes of patients' presentation to emergency departments, and their management represents a clinical challenge. They are usually described as 'hypertensive crises', 'hypertensive urgencies', terms that should be abandoned because they are misleading and inappropriate according to a recent task force of the European Society of Cardiology, which recommended to focus only on 'hypertensive emergencies'. The latter can be esasily identified by using the Brain, Arteries, Retina, Kidney, and/or Heart (BARKH) strategy as herein described. Read More

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January 2022

Midodrine overdose in children: a case report and review of treatment for hypertensive emergencies.

Transl Pediatr 2021 Sep;10(9):2398-2401

Department of Pediatrics, Division of Pediatric Critical Care, University of Florida College of Medicine - Jacksonville, Jacksonville, FL, USA.

Midodrine is an antihypotensive agent used primarily in the adult population for orthostatic hypotension and reflex syncope, postural orthostatic tachycardia syndrome (POTS), and hemodialysis-induced hypotension. Limited information about midodrine ingestion and overdose exists in children with only a single case series reported in the literature. Varying presentations of midodrine ingestion in children have not been shown to be acutely life-threatening in doses up to 50 mg. Read More

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September 2021

Retinal arterial pulsation as an indicator of raised intraocular pressure.

SAGE Open Med Case Rep 2021 26;9:2050313X211054633. Epub 2021 Oct 26.

Royal Victoria Infirmary, Newcastle upon Tyne, UK.

Ophthalmic emergencies are invariably challenging for the non-specialist to identify and evaluate, and may be complicated by occult but vision threatening raised intraocular pressure. We present a case of hypertensive uveitis accompanied by the finding of retinal arterial pulsation, which when visualised by direct ophthalmoscopy allows the non-specialist to identify significantly raised intraocular pressure requiring urgent evaluation by an ophthalmologist. Read More

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October 2021

Profile and management of hypertensive urgencies and emergencies in the emergency cardiology department of a tertiary hospital: a 12-month registry.

Eur J Prev Cardiol 2022 02;29(1):194-201

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

Aims: Currently there are scarce epidemiological data regarding prevalence, clinical phenotype, and therapy of hypertensive urgencies (HU) and emergencies (HE). The aim of this article was to record the prevalence, clinical characteristics, and management of patients with HU and HE assessed in an emergency department (ED) of a tertiary hospital.

Methods And Results: The population consisted of patients presenting with HE and HU in the ED (acute increase in systolic blood pressure (BP) ≥ 180 mmHg and/or diastolic BP ≥120 mmHg with and without acute target organ damage, respectively). Read More

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February 2022

Management of hypertensive emergencies and urgencies: narrative review.

Postgrad Med J 2021 Oct 20. Epub 2021 Oct 20.

Medical Units of Dumfries and Galloway Royal Infirmary, Dumfries, UK

Hypertensive emergencies are distinguished from hypertensive urgencies by the presence of clinical or laboratory target organ damage. The most common forms of target organ damage in developed countries are pulmonary oedema/heart failure, acute coronary syndrome, ischaemic and haemorrhagic stroke. In the absence of randomised trials, it is inevitable that guideline writers differ slightly regarding the speed and extent to which blood pressure should be lowered acutely. Read More

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October 2021

Ventricular Septal Defect in Delayed Presentation of ST-Elevation Myocardial Infarction (STEMI) Secondary to COVID-19 Pandemic.

Cureus 2021 Sep 12;13(9):e17913. Epub 2021 Sep 12.

Cardiology, Broomfield Hospital, Chelmsford, GBR.

Like many other countries at the moment, the United Kingdom (UK) is currently under national lockdown due to the coronavirus disease 2019 (COVID-19) pandemic. An unfortunate consequence of such social isolation measures is that patients with genuine acute medical emergencies may not present to a hospital in a timely manner. We present such a scenario, whereby a patient had a delayed presentation of ST-elevation myocardial infarction (STEMI) due to fear of breaching COVID-19 lockdown rules. Read More

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September 2021

Pharmacotherapy for hypertensive urgency and emergency in COVID-19 patients.

Expert Opin Pharmacother 2022 Feb 20;23(2):235-242. Epub 2021 Oct 20.

Department of Medicine, and Centro Di Ricerca Clinica E Traslazionale (CERICLET), University of Perugia, Perugia, Italy.

Introduction: Hypertension is a common chronic disorder in patients hospitalized for coronavirus disease 2019 (COVID-19). Furthermore, an exaggerated cardiovascular response with persistently raised blood pressure during hospitalization seems independently associated with in-hospital all-cause mortality, intensive care unit admission and heart failure. However, the real burden of elevated blood pressure during the acute phase of COVID-19 remains undefined. Read More

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February 2022

Posterior Reversible Encephalopathy Syndrome: Nitroglycerine a Friend or a Foe?

J Obstet Gynaecol India 2021 Aug 2;71(4):437-439. Epub 2021 Jan 2.

Department of Anaesthesiology, Pain and Critical Care, AIIMS Raipur, Raipur, Chhattisgarh India.

Posterior reversible encephalopathy syndrome (PRES) refers to a clinico-radiological entity with characteristic features on neuroimaging and rapid onset of nonspecific symptoms including headache, seizure, altered consciousness and visual disturbance. It is a neurotoxic state in response to the acute changes in blood pressure leading to vasogenic oedema. It is often but not always associated with hypertension. Read More

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CE: Hypertensive Emergencies: A Review.

Am J Nurs 2021 10;121(10):24-35

Kartavya Sharma is an assistant professor in the Departments of Neurology and Neurological Surgery at the University of Texas Southwestern Medical Center, Dallas, where Essie P. Mathews is an advanced practice RN in the Department of Neurology and Faith Newton is an adult-gerontology acute care NP in the Department of Neurology. Contact author: Kartavya Sharma, The authors and planners have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the authors is available at www.ajnonline.com.

Abstract: While acute blood pressure elevations are commonly seen in the ED, not all require emergency treatment. True hypertensive emergencies are characterized by a rapid elevation in blood pressure to a level above 180/120 mmHg and are associated with acute target organ damage, which requires immediate hospitalization for close hemodynamic monitoring and IV pharmacotherapy. Recognizing the clinical signs and symptoms of hypertensive emergency, which may vary widely depending on the target organ involved, is critical. Read More

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October 2021

[Vascular emergencies in pregnant patients : Peripartum hemorrhage, thromboembolic events and hypertensive diseases in pregnancy].

Anaesthesist 2021 10 8;70(10):895-908. Epub 2021 Sep 8.

Klinik für Anästhesiologie und Intensivmedizin, Klinikum Neumarkt i.d.OPf., 92318, Neumarkt, Deutschland.

In developed countries, peripartum hemorrhage, thromboembolic events and hypertensive pregnancy disorders are the most frequent complications in pregnancy. They pose a significant challenge for the interdisciplinary team of gynecology and anesthesiology. Untreated, these pregnancy-related complications result in a fulminant course. Read More

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October 2021

[Hypertensive urgencies and emergencies in pediatric patients].

Pol Merkur Lekarski 2021 08;49(292):306-310

Medical University of Warsaw: Department of Pediatrics and Nephrology.

Hypertensive crisis is a sudden rise in blood pressure that is significantly above normal values. Depending on the severity of symptoms, hypertensive crisis can be classified as hypertensive urgency, i.e. Read More

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