Table 14.
The evaluation of hypertension urgency and emergency
| Parameter | Severe hypertension (Urgency) |
Hypertension emergency | |
|---|---|---|---|
| Asymptomatic | Symptomatic | ||
| Blood pressure | > 180/110 mmHg | > 180/110 mmHg | Usually ≥ 220/140 mmHg |
| Symptoms | Headache, anxiety, often asymptomatic | Severe headache, shortness of breath, nose bleeding | Shortness of breath, chest discomfort, nocturia, dysarthria,weakness, altered consciousness |
| Examination | No TOD, no clinical cardiovascular disease | TOD; clinical cardiovascular disease present, stable | Encephalopathy, pulmonary edema, renal insufficiency,cerebrovascular accident, cardiac ischemia |
| Therapy | Observe 1-3 hours, initiate or resume medication, increase dosage ofinadequate agent | Observe 3-6 hours, lower BP with short-acting oral agent, adjustcurrent therapy | Baseline laboratory tests, intravenous line, monitor BP, mayinitiate parenteral therapy in emergency room |
| Plan | Arrange follow-up within 3-7 days | Arrange follow-up evaluation in less than 72 hours | Immediate admission to critical care unit, treat to initial goal BP,additional diagnostic studies |
TOD: Target organ damage