Hypertensive Emergency

Hypertensive Emergency – General Information

The Hypertensive Emergency is the severe hypertension (meaning a high blood pressure) of one of the organ systems (such as cardiovascular system, renal system, central nervous system, etc). This medical condition leads to irreversible organ damage and the high blood pressure must be lowered with an antihypertensive agent. There are many antihypertensive drugs can be recommended by the doctor or personal health care provider but the choice depends on the causes of the Hypertensive Emergency and on how elevated is the blood pressure. Although it is not available in all of the emergency cases, it is recommended for the patients to receive an intravenous sodium nitroprusside injection, as this has a rapid antihypertensive effect. In the cases which are not very urgent, the patients may take oral medicines such as: Prazosin, Captopril, Clonidine or Labetalol which reduce the blood pressure, but slower than the nitroprusside. The doctors usually recommend that the blood pressure to be lowered smoothly and not abruptly. The primary goal in the patients who are suffering from Hypertensive Emergency is to reduce the blood pressure by 30% (in maximum two hours). The repeated reductions in the blood pressure may lead to the precipitation of the renal ischemia, coronary ischemia or even cerebral ischemia. When the doctor establishes a diagnosis he does not take in consideration only the high blood pressure, but also the normal blood pressure which the patient had before the hypertensive crisis. For the patients who have a history of chronic hypertension it is not necessary to have a normal blood pressure.

Hypertensive Emergency – Symptoms

It is well known the fact that any medical disorder (including Hypertensive Emergency) can trigger a variety of symptoms. Therefore, some of this medical condition's most uncommon symptoms have not been listed (mentioned) here. This is why we strongly recommend you to contact your personal health care provider whenever you develop any unusual, bothersome or unpleasant symptoms. Your personal physician will be able to tell you if you are suffering from Hypertensive Emergency or from any other medical disorder. Here is a list of the most common symptoms that a person who suffers from this medical condition, may experience, although in the majority of the cases the patients are asymptomatic. In rare cases the patients may have headaches which are mild; in the cases in which the headaches are severe the patients may be suffering from malignant Hypertensive Emergency and can also experience confusion, crushing angina, ear noise, blood in the urine, buzzing, nosebleed, tiredness, irregular heartbeat and even vision changes. In most of the cases the patients ignore these symptoms and they do not go to see a doctor until they have an organ damage which gives them stronger symptoms. The organ damage is caused by the high blood pressure and it can lead to: heart attack and heart failure, stroke, kidney failure, aneurysms, peripheral arterial diseases, and eye damage which can lead to the permanent loss of the vision. This is why it is very important in the cases that a person experiences any of the symptoms listed above to contact his doctor or health care provider, in order to reduce the risk of the complications development.

Hypertensive Emergency – Treatment

It is important to treat the Hypertensive Emergency, in order to prevent some serious, life threatening complications. The doctor or the health care provider can propose the patients to follow some steps which will help them to lower the high blood pressure by controlling the conditions which can lead to the elevated blood pressure. Such medical conditions which can contribute to the rise of the blood pressure are high cholesterol and even diabetes. The doctor may recommend the patients, who are suffering from Hypertensive Emergency to make some lifestyle changes in order to control their blood pressure, but unfortunately these lifestyle changes are not always enough and in these cases the doctors recommend to the patients to make exercises and also to take medications. The medication treatment which the doctor or personal health care provider prescribes to the patients depends on how high is the blood pressure and on the general health of the patients.

The medications which are usually prescribed by the doctors or personal health care providers to the patients who are suffering from Hypertensive Emergency are the following:

• Beta Blockers – these drugs work by reducing the workload of the heart making the heartbeat slower. These drugs have a greater effect if they are prescribed among with a Thiazide diuretic.
  
• Thiazide diuretics – these drugs help the kidneys to eliminate the water and sodium, in order to reduce the blood pressure. These drugs are one of the many key factors which help the patients to prevent the heart failure.
  
• Angiotensin converting enzyme inhibitors (also abbreviated ACE) – these are medicines which help the blood vessels to relax and are very important in the people who are also suffering from coronary artery disease, kidney failure or heart failure. Theses drugs are also more effective when combined with Thiazide diuretics.
  
• Angiotensin II receptor blockers – these are also medications which help the blood vessels to relax.
  Calcium channel blockers – these drugs help the muscles of the blood vessels to relax and also they help to slow down the patients’ heart rate. During the treatment with calcium channel blocker the patients are not allowed to eat grapefruits as some of the components of these drugs interfere with the grapefruit juice.
  
• Renin inhibitors – these drugs work be inhibiting an enzyme which is produced by the kidneys and which leads to high blood pressure.
  

• Alpha blockers – these drugs reduce the nerve impulses to the blood vessels.
• Alpha – beta blockers – these drugs slow down the heart beat.
• Vasodilators – these drugs are used in order to dilate the muscles of the blood vessels and prevent them from tightening.

When the blood pressure is under control the doctor usually recommend the patients who are suffering from Hypertensive Emergency to take aspirin in order to reduce the risk of developing a cardiovascular disease.