Hypertensive urgency

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Hypertensive urgency, also called accelerated hypertension, involves a diastolic blood pressure of greater than 130mm, and may have exudates and hemorrhages present. It does not, however, demonstrate the end-organ failure characteristic of malignant hypertension, but still needs immediate attention.

This attention, in the emergency department, means observation and assessment, but not necessarily the rapid reduction of blood pressure, using parenteral agents, which would be carefully appropriate for end-organ failure. A patient can be discharged to outpatient followup, once severe disease has been ruled out.

Treatment[edit]

A third of patients will improve with rest.^[1]

Various antihypertensive agents are effective. In comparisons of nifedipine and clonidine, clonidine may cause more sedation^[2][3]. Repeated doses of clonidine is not needed.^[4]

References[edit]