CASE REPORT: HYPERTENSIVE CRISIS BLOCK 5

HYPERTENSION REVIEW of CONCEPTS

CLASSIFYING HTN JNC 7 (2003) ESH-ESC (2007) 2007 Guidelines for the Management of Arterial Hypertension. Journal of Hypertension. 2007;25:1105–1187. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–1252.

CLASSIFYING HTN 2007 Guidelines for the Management of Arterial Hypertension. Journal of Hypertension, 2007, 25:1105–1187

CLASSIFYING HTN 2007 Guidelines for the Management of Arterial Hypertension. Journal of Hypertension, 2007, 25:1105–1187

CLASSIFYING HTN 2007 Guidelines for the Management of Arterial Hypertension. Journal of Hypertension, 2007, 25:1105–1187

HTN: END-ORGAN DAMAGE SIGNS of END-ORGAN DAMAGE BRAIN: neck artery murmurs, sensory or motor deficits RETINA: fundoscopic abnormalities HEART: displaced or abnormal apical impulse, abnormal cardiac rhythms, ventricular gallop, pulmonary rales, peripheral edema PERIPHERAL ARTERIES: assymetry or reduction of pulses, cold extremities, ischemic skin lesions CAROTID ARTERIES: systolic murmur 2007 Guidelines for the Management of Arterial Hypertension. Journal of Hypertension, 2007, 25:1105–1187

HTN CRISIS: URGENCY or EMERGENCY HTN URGENCY HTN EMERGENCY …severe elevation of BP without progressive target organ dysfunction …severe elevation of BP complicated by evidence of impending or progressive target organ dysfunction Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–1252.

HTN URGENCY HTN EMERGENCY HTN CRISIS: TREATMENT HTN URGENCY HTN EMERGENCY OUTPATIENT or SAME-DAY OBERVATION Oral antihypertensives GOAL: no more than 25% MAP reduction in 1st 24 hours INPATIENT or INTENSIVE CARE Parenteral drugs GOAL: 10% MAP reduction in 1st hour; 15% reduction in next 2-3 hours Hypertensive Urgency and Emergency, Resident Rounds. Hospital Physician. March 2007:43-50