1. CASE REPORT: HYPERTENSIVE CRISIS
BLOCK 5

2. HYPERTENSION
REVIEW of CONCEPTS

3. CLASSIFYING HTN JNC 7 (2003) ESH-ESC (2007)
2007 Guidelines for the Management of Arterial Hypertension. Journal of Hypertension. 2007;25:1105–1187.
Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–1252.

4. CLASSIFYING HTN
2007 Guidelines for the Management of Arterial Hypertension. Journal of Hypertension, 2007, 25:1105–1187

5. CLASSIFYING HTN
2007 Guidelines for the Management of Arterial Hypertension. Journal of Hypertension, 2007, 25:1105–1187

6. CLASSIFYING HTN
2007 Guidelines for the Management of Arterial Hypertension. Journal of Hypertension, 2007, 25:1105–1187

7. HTN: END-ORGAN DAMAGE SIGNS of END-ORGAN DAMAGE
BRAIN: neck artery murmurs, sensory or motor deficits
RETINA: fundoscopic abnormalities
HEART: displaced or abnormal apical impulse, abnormal cardiac rhythms, ventricular gallop, pulmonary rales, peripheral edema
PERIPHERAL ARTERIES: assymetry or reduction of pulses, cold extremities, ischemic skin lesions
CAROTID ARTERIES: systolic murmur
2007 Guidelines for the Management of Arterial Hypertension. Journal of Hypertension, 2007, 25:1105–1187

8. HTN CRISIS: URGENCY or EMERGENCY
HTN URGENCY
HTN EMERGENCY
…severe elevation of BP without progressive target organ dysfunction
…severe elevation of BP complicated by evidence of impending or progressive target organ dysfunction
Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–1252.

9. HTN URGENCY HTN EMERGENCY
HTN CRISIS: TREATMENT
HTN URGENCY
HTN EMERGENCY
OUTPATIENT or
SAME-DAY OBERVATION
Oral antihypertensives
GOAL: no more than 25% MAP reduction in 1st 24 hours
INPATIENT or INTENSIVE CARE Parenteral drugs GOAL: 10% MAP reduction in 1st hour; 15% reduction in next 2-3 hours
Hypertensive Urgency and Emergency, Resident Rounds. Hospital Physician. March 2007:43-50