Hypertension | Guidelines and Management

Guidelines for cases of hypertensive emergencies

The American College of Emergency Physicians (ACEP), in 2013, issued guidelines for hypertensive patients in the emergency department, which focus on cases of hypertensive urgency (asymptomatic severe high blood pressure).

    • Cases of hypertensive urgency, in the emergency department, should have routine examination for multi-organ damage.
    • In the emergency department, doctors may treat high blood pressure and start a long-term treatment plan to control hypertension.
    • Doctors should refer their patients to regular follow-ups at outpatient clinics.

The American College of Cardiology/American Heart Association (ACC/AHA) in 2017 guidelines focuses on cases of hypertensive emergency (severe high blood pressure with symptoms of multi-organ damage).

    • In cases of hypertensive emergency, doctors should start intravenous therapy and continuous evaluation of blood pressure and multi-organ damage, at the intensive care unit (ICU).
    • Our initial goal, in these cases, is to lower blood pressure by less than 25% in the first hour. If the patient is still stable, we will lower blood pressure to 160/110 mmHg in the next 2-6 hours. If the patient is still stable after these reductions, we will lower blood pressure to a normal level in the next 24-48 hours.

» Now, we will discuss the guidelines for the management of hypertension in pregnancy to know the different ways to protect the pregnant mother and her baby.