A sudden rise in blood pressure can result in either a hypertensive crisis or a hypertensive urgency.
Patient selection: significant rise in blood pressure
A significant rise in blood pressure has been defined as:
(1) a systolic blood pressure > 200 mm Hg
(2) a diastolic blood pressure > 110, > 120. > 130 or > 140 mm Hg
(3) an absolute or relative increase above baseline readings
Term
Clinical Features
emergency (crisis)
evidence of end-organ damage - one or more of the following: encephalopathy, nephropathy, ischemic heart disease, TIA or stroke, dissecting aortic aneurysm, acute pulmonary edema or other significant organ damage
urgency (pseudocrisis)
no evidence of end-organ damage
A patient with a hypertensive emergency needs to have a rapid reduction in the blood pressure to a safer level, often using parenteral drug therapy.
A patient with hypertensive urgency can undergo a slower reduction in the blood pressure over hours or days.
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