(Hypertensive Emergency; Hypertensive Crisis; Hypertensive Urgency)
|Cardiovascular System and Kidneys|
|Copyright © Nucleus Medical Media, Inc.|
- History of kidney disorders or failure
- Taking certain drugs or medications, including cocaine, amphetamines, monoamine oxidase inhibitors (MAOIs), and oral contraceptives
- History of collagen vascular diseases
- Pregnant women with preeclampsia and eclampsia
- Spinal cord disorders
- Coarctation or dissection of the aorta
- Renal artery stenosis or narrowing of the arteries to the kidneys
- Missing doses of prescribed antihypertensive medications, particularly beta-blockers or clonidine (Catapres), which can cause a rebound effect. Medication noncompliance is the most common reason for hypertensive emergencies.
- African American
- A smoker
- Chest pain
- Difficulty breathing
- Visual problems
- Nausea and vomiting
- Numbness/weakness of the legs, arms, face
- Blood tests for BUN and creatinine levels to check for kidney damage
- Chest x-ray
- Echocardiogram or ultrasound of the heart to look for heart damage
- Urine tests for high levels of protein, small amounts of blood or abnormally high levels or certain hormones
- EKG to look at the heart’s electrical functioning
- Renal duplex or ultrasound test of the kidney's arteries to look for blockage
Intravenous high blood pressure medications–The specific medication will be chosen based on your specific situation, including whether you are suffering from damage to your kidneys or other organs. Possible medications may include:
- Sodium nitroprusside or nitroglycerin
- Vasotec (enalapril) and ACE-inhibitor
- Oral high blood pressure medicines once blood pressure has been lowered from dangerous levels
- Frequently check your blood pressure levels.
- Report any sustained high blood pressure to your healthcare provider.
- Take all prescribed high blood pressure medicines regularly and avoid missing doses.
American Heart Association http://www.americanheart.org
National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov
The Canadian Hypertension Society http://www.hypertension.ca
The Society of Obstetricians and Gynaecologists of Canada (SOGC) http://www.sogc.org
Elliot WJ. Clinical features and management of selective hypertensive emergencies. J Clin Hypertens . 2004;6(10):587-92.
Tuncel M, Ram VC. Hypertensive emergencies: etiology and management. Am J Cardiovasc Drugs . 2003;3(1):21-31.
Van den Born BJ, Honnebier UP, Koppmans RP, van Montfrans GA. Microangiopathic hemolysis and renal failure in malignant hypertension. Hypertension . February 2005;45(2):246-51.
- Reviewer: Michael J. Fucci, DO
- Review Date: 09/2013 -
- Update Date: 09/30/2013 -