Hypertensive Emergency

Overview

Hypertensive emergency is defined as severe elevation of blood pressure (180/110 mmHg) associated with newly existing or progressive end organ damages or complications such as acute heart failure, dissecting aneurysm, acute renal failure, acute coronary syndromes, hypertensive encephalopathy, subarachnoid haemorrhage and/or intracranial haemorrhage

Signs and Symptoms

Chest pain, Changes in mental status such as confusion, Difficulty breathing or breathlessness, Systolic blood pressure >180mmHg and diastolic blood pressure >110mmHg, Seizures, Headache, Blurring of vision, Swelling or edema

Common Causes

Underlying hypertensive disease, Stroke, Heart failure, Kidney failure, Severe preeclampsia in pregnant women, Defaulted anti-hypertensive treatment or not taking medications constantly

Risk Factors

Underlying hypertension, Underlying hypertensive diseases, Age, Hypertension during pregnancy

Investigation Techniques

Monitor blood pressure regularly, Full blood count, Urine analysis, Urine FEME, Eye examination, Renal function test

Treatment and Prevention

Admit patient for immediate intervention and monitoring, Reduce BP rapidly but only reduced by 10%-25% within certain minutes to hours however not lower than 160/90 mmHg