Very high BP. DBP usually >120, but NO acute end organ damage (encephalopathy, angina, papilloedema etc)
Hypertensive urgency (severe asymptomatic hypertension):
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A) No proven benefit from rapid reduction of the blood pressure in patients with severe asymptomatic hypertension.
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B) In fact cerebral or myocardial ischemia or infarction can be induced with aggressive antihypertensive therapy if the blood pressure falls below the range at which tissue perfusion can be maintained by autoregulation.
N.B:- This has been most often described withZ sublingual nifedipine or captopril; the degree of blood pressure reduction cannot be controlled or predicted, and severe ischemic complications have ensued.
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C) The goal of management is to reduce the blood pressure to <160/100 mmHg over several hours to days.