A LITERATURE REVIEW ON HYPERTENSIVE CRISIS

Shanker K. C., Prateek Raj Karnikar, Hu Deng and Wang Zhi Quan*

ABSTRACT

Hypertension (HTN) is a leading cause of global disease, mortality, and disability. In developed countries because of increased awareness regarding the health and widespread availability of antihypertensive drug, there has been decreased in the number of patient visiting to primary physician due to increased “crisis level” of blood pressure (BP). Thus, only few patients with the history of HTN or pervious use of antihypertensive drugs can automatically developed hypertensive crisis (HC). HC are the acute medical problem seen in the clinical practice and also most misunderstood and mismanage problem. HC can be divided into hypertensive urgencies (HU) and hypertensive emergencies (HE). This classification is extremely useful in clinical practice because according to this classification, the management to the patient can be judge like, to give oral medication or parental medication, to hospitalize the patient or not, who low and how fast should we go to reduce the BP. Due to lack of knowledge most of the physician, aggressively revert the elevated blood pressure which in turn cause more harm to the patient and is associated in increasing the rate of morbidity and death. The aim of this narrative review is to summarize the basis concept, misconceptions and pitfalls of HC, to improve the public awareness, recognition the risk factor, how to diagnose, how to treat the patient of HC present in the emergency department (ED). (Pre-eclampsia and eclampsia related to pregnancy induced hypertension is not included in this review.)

Keywords: Hypertension, Hypertensive Crisis, Hypertensive Emergencies, Hypertensive Urgencies, Pathophysiology, Management.