Hypertensive urgency
- Do not use this diagnosis, see asymptomatic hypertension
Background
- Elevation in BP without acute end-organ damage
Clinical Features
Categorization of Hypertension[1]
- Asymptomatic hypertension
- Systolic BP 140-179 or diastolic BP 90-109
- Asymptomatic
- Hypertensive urgency^
- Systolic BP ≥ 180 or diastolic BP ≥ 110
- No evidence of end-organ dysfunction
- Hypertensive emergency
- Systolic BP ≥ 180 or diastolic BP ≥ 110
- Evidence of end-organ dysfunction
^Many emergency physicians do not use the diagnosis of "hypertensive urgency," but utilize instead only hypertensive emergency (signs of end organ dysfunction) or asymptomatic hypertension (all others)
Differential Diagnosis
Hypertension
- Hypertensive emergency
- Stroke
- Sympathetic crashing acute pulmonary edema
- Ischemic stroke
- Intracranial hemorrhage
- Preeclampsia/Eclampsia
- Autonomic dysreflexia
- Scleroderma renal crisis
- Acute glomerulonephritis
- Type- I myocardial infarction
- Volume overload
- Urinary obstruction
- Drug use or overdose (e.g stimulants, especially alcohol, cocaine, or Synthroid)
- Renal Artery Stenosis
- Nephritic and nephrotic syndrome
- Polycystic kidney disease
- Tyramine reaction
- Cushing's syndrome
- Obstructive sleep apnea
- Pheochromocytoma
- Hyperaldosteronism
- Hyperthyroidism
- Anxiety
- Pain
- Oral contraceptive use
Evaluation
Management
Disposition
See Also
References
- ↑ Levy PD. Hypertensive Emergencies — On the Cutting Edge. EMCREG - International. 2011. 19-26.