This chapter will review the pharmacotherapy for treatment of high blood pressure according to the 2017 High Blood Pressure Clinical Practice Guideline.
Definitions
Hypertensive urgency
Severe elevations in blood pressure (>180/120 mm Hg) without target organ damage.
Hypertensive emergency
Severe elevations in blood pressure (>180/120 mm Hg) with target organ dysfunction (e.g., chest pain, vision changes, acute kidney injury, aortic dissection, acute shortness of breath, heart failure exacerbation, obtundation).
Management
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Hypertensive crisis ( Fig. 5.1 )
Figure 5.1
Diagnosis and Management of Hypertensive Crisis.
From Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:e127–e248 . BP , blood pressure; Class I , Strong recommendation; DBP , Diastolic blood pressure; ICU , Intensive care unit; SBP , Systolic blood pressure. *Use medication specified in Table 5.1 . † If other comorbidities present, select a medication specified in Table 5.1 .
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Hypertension in acute intracerebral hemorrhage ( Fig. 5.2 )
Figure 5.2
Management of Hypertension in Acute Intracerebral Hemorrhage (ICH).
From Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:e127–e248 . BP , Blood pressure; Class IIa , Can be beneficial; Class III , No benefit; IV , intravenous; SBP , systolic blood pressure.
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Hypertension in acute ischemic stroke ( Fig. 5.3 )
Figure 5.3
Management of Hypertension in Acute Ischemic Stroke.
From Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:e127–e248 . BP , Blood pressure; Class I , Strong recommendation; Class IIa , Moderate recommendation (can be beneficial); Class IIb , Weak recommendation; Class III , No benefit; DBP , Diastolic blood pressure; IV , intravenous; SBP , systolic blood pressure.Related posts:
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