Hypertensive Crisis, Urgency and Emergency

Hypertensive crisis is a dangerous stage of hypertension, at which blood pressure reaches life-threatening levels (180/120mm Hg or higher). Hypertension is an asymptomatic disease, which may lead to this stage without prominent warning signs in most patients.

This stage may occur in two forms: hypertensive urgency and hypertensive emergency.

  1. Hypertensive urgency refers to the extreme elevation of blood pressure without multi-organ damage. It is easier to control blood pressure in this form of hypertensive crisis and safely reduce blood pressure readings with oral medications only. It is more common and represents three-fourths of hypertensive crisis cases. In this stage, there is a high risk of hypertensive emergency, which is a life-threatening condition.
  2. Hypertensive emergency refers to an extreme elevation of blood pressure with multi-organ damage. It is a life-threatening condition that requires an immediate blood pressure control in the intensive care unit (ICU). It is rare and represents only one-fourth of cases of hypertensive crisis.

Now, let’s discuss important questions about the hypertensive crisis:

  • What are the causes of the hypertensive crisis?
  • What are the symptoms of the two forms of hypertensive crisis?
  • What is the best way to manage patients in a hypertensive crisis? And what we should do in case of a hypertensive emergency?