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



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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