Definitions and Recognition
BP >180/120 mm Hg plus evidence of acute target organ damage.
What is a hypertensive emergency?
The maximum percent SBP reduction in the first hour for a hypertensive emergency with no compelling condition.
What is 25%?
This IV dihydropyridine CCB is contraindicated in patients with soybean or egg allergy. Hint: we don't have it here at UI Health :(
What is clevidipine?
This drug class is contraindicated in hypertensive emergency with acute pulmonary edema.
What are beta blockers?
In severe hypertension without acute target organ damage, this route of antihypertensive therapy should not be given.
What is parenteral (IV)?
The 2025 guideline’s term for BP >180/120 mm Hg without acute target organ damage. It replaces “hypertensive urgency.”
What is severe hypertension?
The SBP target within the first hour for aortic dissection.
What is <120 mm Hg?
This IV vasodilator should be used only in patients with acute coronary syndrome and/or acute pulmonary edema.
What is nitroglycerin?
The two agents of choice for hypertensive emergency with acute coronary syndrome.
What are esmolol and nitroglycerin?
A patient with severe hypertension and no acute target organ damage is found in the outpatient setting. The guideline says there’s no need to send them here.
What is the emergency department/hospital
The COR 1 recommendation for where to admit a patient with a hypertensive emergency, for continuous BP and organ monitoring.
What is the ICU?
The SBP target within the first hour for most compelling conditions other than aortic dissection.
What is <140 mm Hg?
This direct vasodilator is an undesirable first-line agent for most patients because its response is unpredictable and its action is prolonged.
What is hydralazine?
The two preferred agents for acute aortic dissection, which should be given before any vasodilator.
What are esmolol and labetalol?
Before giving an antihypertensive for a high BP reading in a hospitalized patient, name 2 reversible causes you should check for and treat first.
Name 3 forms of acute target organ damage that make severe hypertension a hypertensive emergency.
With no compelling condition and a stable patient, the BP target over the next 2–6 hours.
What is <160/100 mm Hg?
With this agent, cyanide and thiocyanate toxicity can occur at infusion rates ≥3 mcg/kg/min and/or a duration ≥3 days.
What is sodium nitroprusside?
Name 2 of the 3 preferred agents for hypertensive emergency with acute kidney injury.
What are clevidipine, fenoldopam, and nicardipine?
In hospitalized patients with asymptomatic severe hypertension, the percentage whose BP falls on its own without any antihypertensives.
What is 40–50%?
The in-hospital mortality rate for patients with a hypertensive emergency.
What is 10%? Bonus: 1-year cardiovascular morbidity and mortality is 20–30%.
The SBP range to reach cautiously over the following 24–48 hours.
What is 130–140 mm Hg?
Tachyphylaxis is common with extended use of these two vasodilators.
What are sodium nitroprusside and nitroglycerin?
In acute aortic dissection, beta blockade should come before a vasodilator like nicardipine or nitroprusside. Give the reason.
What is preventing reflex tachycardia or an inotropic effect?
In patients with longstanding hypertension, this physiologic process shifts to higher pressures. That shift is why rapidly normalizing BP can cause cerebral, coronary, or renal hypoperfusion.
What is autoregulation