Hypertensive crisis

Source: Wikipedia, the free encyclopedia.
See also: Hypertensive emergency and Hypertensive urgency

Severely elevated

diastolic) is referred to as a hypertensive crisis (sometimes termed malignant or accelerated hypertension), due to the high risk of complications. People with blood pressures in this range may have no symptoms, but are more likely to report headaches (22% of cases)[1] and dizziness than the general population.[2] Other symptoms accompanying a hypertensive crisis may include visual deterioration due to retinopathy, breathlessness due to heart failure, or a general feeling of malaise due to kidney failure.[3]

Most people with a hypertensive crisis are known to have elevated blood pressure, but additional triggers may have led to a sudden rise.[4]

Symptoms & treatment

A "

left ventricle of the heart to adequately pump blood from the lungs into the arterial system.[4] Rapid deterioration of kidney function (acute kidney injury) and microangiopathic hemolytic anemia (destruction of blood cells) may also occur.[4]

In these situations of hypertensive emergency, rapid reduction of the blood pressure is mandated to stop ongoing organ damage.[4] In contrast there is no evidence that blood pressure needs to be lowered rapidly in hypertensive urgencies, where there is no evidence of target organ damage; over-aggressive reduction of blood pressure is not without risks.[3] Use of oral medications to lower the BP gradually over 24 to 48h is advocated in hypertensive urgencies.[4]

Etiologies

There are several etiologies of a hypertensive crisis, including a tumor. A rare, neuroendocrine tumor called a pheochromocytoma can cause a hypertensive crisis due to elevated levels of catecholamines.[6][7]

References

  1. S2CID 207471870
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  2. ISBN 978-0-07-139140-5
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  3. ^
    ISBN 978-1-4051-3061-5
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  4. ^
    PMID 17565029
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  5. PMID 14656957
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  6. PMID 28670069
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  7. PMID 33833909
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