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Eur Heart J Cardiovasc Pharmacother. 2018 Aug 25. doi: 10.1093/ehjcvp/pvy032. [Epub ahead of print]

ESC Council on hypertension position document on the management of hypertensive emergencies.

Author information

1
Department of Internal Medicine, Division of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
2
Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.
3
Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Faculty of Health, Aalborg University, Aalborg, Denmark.
4
Hypertension Division, University Medical Centre Ljubljana, Department of Internal Medicine, Dr. Peter Držaj Hospital, Ljubljana, Slovenia.
5
Hypertension Unit, Department of Cardiology, Hopital Saint André and University Hospital of Bordeaux, Bordeaux, France.
6
Hypertension Unit, Department of Nephrology, Hospital 12 de Octubre, Madrid, Spain.
7
Department for Internal Medicine III, Cardiology, Angiology, and Intensive Care Medicine, Saarland University, Homburg/Saar, Germany.
8
Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.
9
Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Cardiovascular Medicine, Stockholm, Sweden.
10
Clinica Medica Generale, Department of Clinical and Experimental Sciences, University of Brescia, and Department of Medicine, Azienda Spedali Civili di Brescia, Brescia, Italy.
11
Hypertension Research Center, Department of Translational Medical Sciences, Federico II University Hospital, Naples, Italy.
12
University College London (UCL) and UCL Hospitals, London, UK.

Abstract

Hypertensive emergencies are those situations where very high blood pressure (BP) values are associated with acute organ damage, and therefore, require immediate, but careful, BP reduction. The type of acute organ damage is the principal determinant of: (i) the drug of choice, (ii) the target BP, and (iii) the timeframe in which BP should be lowered. Key target organs are the heart, retina, brain, kidneys, and large arteries. Patients who lack acute hypertension-mediated end organ damage do not have a hypertensive emergency and can usually be treated with oral BP-lowering agents and usually discharged after a brief period of observation.

PMID:
30165588
DOI:
10.1093/ehjcvp/pvy032

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