Diagnosis and management of the hypertensive crisis [Diagnóstico y tratamiento de la crisis hipertensiva]

Patients presenting to emergency departments with severe hypertension need prompt evaluation to establish the presence of a hypertensive emergency or urgency. Patients with hypertensive emergencies have severe hypertension and constitute a distinct group of clinic pathologic entities associated with acute target organ injury. These patients require immediate blood pressure reduction to prevent progressive end-organ damage and are best treated in an intensive care unit with treatable parenteral hypotensive agents. Those with hypertensive urgencies can be managed on an ambulatory basis with initiation or adjustment of appropriate oral antihypertensive therapy. There is no predetermined level for the goal of therapy; however, special care should be taken to avoid abrupt hypotension. There are a number of highly effective drugs available to treat patients experiencing these crises