Hypertensive crisis

Internal Medicine

• Very high BP, systolic usually > 180 & diast. > 120
• BP should be lowered gradually over few hours, to about 110-100 Diastolic.
• Oral medicines can be given ( but not TAHT-AL LISAAN !
• HTN emergency needs ICU admission & i.v. meds.
  • nitroglycerin * nitroprusside
  • i.v. hydralazine * Nicardipine * labetolol
• Don’t “reduce” the BP quickly. Reduce by 10% in the first hour, then slowly. Normalisation can occur over few days.
• Don’t give sublingual medicines. It will cause sudden drop in BP can cause ischemia to the brain
• If not treated timely, hypertensive crisis can cause permanent end organ damage.

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Therapeutics

THERA HTN RENAL STENSOSIS

Very high BP, systolic usually > 180 & diast. > 120

• BP should be lowered gradually over few hours, to about 110-100 Diastolic.
• Oral medicines can be given ( but not TAHT-AL LISAAN !)

HTN emergency needs ICU admission & i.v. meds.

• nitroglycerin   
• nitroprusside 
• i.v. hydralazine
• Nicardipine
• labetolol

Note

• Dont “reduce” the BP quickly. Reduce by 10% in the first hour, then slowly. Normalisation can occur over few days.
• Don’t give sublingual medicines. It will cause sudden drop in BP ⇒ can cause ischemia to the brain
• If not treated timely, hypertensive crisis can cause permanent end organ damage.

Pathological Complications

• Rapidly progressive end organ damage
• May complicate any type of HPTN
• Artery necrosis with thrombosis
• Rapidly developing renal failure
• Hypertensive encephalopathy
• Left ventricular failure