#EM3 - June 8, 2016 - By Rebecca Prest
"Patients who have severe hypertension alongside evidence of end organ damage are treated as hypertensive emergencies. Left untreated irreversible organ damage can occur within hours.
(Click image to enlarge)
Organ damage can include:
- Encephalopathy
- Grade III (retinal haemorrhages, exudates, cotton wool spots and retinal oedema) or Grade IV (papilloedema) retinopathy
- Renal failure
- Acute Coronary Ischaemia
- LV failure
- Aortic dissection (Recently highlighted in anRCEM Safety Alert)
- Eclampsia (see our Previous Sim)
Hypertensive emergencies will usually require intravenous anti-hypertensive therapy aiming for a 25% reduction in blood pressure over 1-4 hours.
Patients with severe hypertension and retinal changes only (Accelerated hypertension) can often be managed with oral therapy such as a long acting calcium channel blocker aiming to reduce diastolic BP to 100mmHg over 24 hours."