Hypertensive urgency

Hypertensive Urgency is a clinical condition characterized by a significant and rapid increase in blood pressure that is not associated with any immediate or progressive target organ damage.

Definition

Hypertensive urgency is defined as a severe elevation in blood pressure (BP) exceeding 180/120 mm Hg without evidence of impending or progressive target organ damage. This condition is distinguished from hypertensive emergency, which is a similar severe elevation in BP but with signs of target organ damage.

Causes

The causes of hypertensive urgency are not well understood. It is thought to be related to a sudden increase in blood pressure due to stress, anxiety, or other factors. Some common causes include:

• Noncompliance with antihypertensive therapy
• Excessive salt intake
• Use of illicit drugs, such as cocaine or amphetamines
• Use of over-the-counter cold and pain medications
• Alcohol withdrawal
• Certain endocrine disorders

Symptoms

Patients with hypertensive urgency may not have any symptoms. When symptoms do occur, they can include:

• Severe headache
• Shortness of breath
• Nosebleeds
• Severe anxiety

Treatment

The goal of treatment in hypertensive urgency is to gradually lower blood pressure over a period of 24 to 48 hours. This is typically achieved with oral antihypertensive medications. Rapid reduction of blood pressure is avoided to prevent the risk of hypotension and acute end-organ damage.

See Also

• Hypertension
• Hypertensive emergency
• Blood pressure
• Antihypertensive therapy