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Crisis of Hypertension Revised 1

Crisis of Hypertension Revised 1



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Published by keenmunir
from Dr Atma Gunawan, Nephrologist
from Dr Atma Gunawan, Nephrologist

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Published by: keenmunir on Jul 26, 2009
Copyright:Attribution Non-commercial


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Management of hypertensive crisis
Atma GunawanConsultant of nephrology &hypertension
HYPERTENSIVE CRISIS- DBP >120 mmHg with the potential of inflicting irreparable damage to targetorgan and endangering patients lives
JNC VII 2003 : ≥ 180/110
Recognition of hypertensive crisis depends on the clinical state of the patients,not on the absolute level of blood pressureForm : HYPERTENSIVE EMERGENCY and HYPERTENSIVE URGENCYMalignant hypertension
a syndrome characterized by elevated BP accompanied byretinal hemorrhages, exudates, or papilledema or acute nephropathy.
Accelerated hypertension :
malignant HT with hemorrhages and exudates alone 
Hypertensive encephalopathy
refers to the presence of signs of cerebral edema
JNC V (1993), JNC VII 2003.
CHEST 2007; 131:1949–1962)
Paul E. Marik, MD
Classification of hypertensive crisis
Hypertensive Urgency
Diastolic BP>120 mmHg, systolic BP>220
Mild or no acute end-organ damage
No clinical symptomsHypertensive Emergency
Usually diastolic BP>120 mmHg, systolicBP>220 mmHg
Acute end organ damage
Clinical symptoms is evident
Pregnant : ≥170/110 mmHg
Post-operative : >190/100 mmHg
(1997) Report of the Canadian Hypertension Society Consensus Conference: 3.Pharmacologic treatment of hypertensive disorders in pregnancy.
Can Med  Assoc J 

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