Abstract
Acute blood pressure (BP) elevation represents a frequent reason of concern for clinicians in everyday clinical practice. The terms “hypertensive emergencies” and “hypertensive urgencies” may be used in order to better define the so called “hypertensive crises”. A hypertensive emergency may be defined as a condition characterized by an acute and severe elevation of blood pressure (BP) associated to a new onset or worsening organ damage (OD). A hypertensive urgency may be defined as a condition characterized by an isolated elevation of BP values without evidence of acute hypertensive OD. This article will review the definition, the prevalence, and the prognostic implications of hypertensive emergencies and urgencies.
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs40292-018-0263-2/MediaObjects/40292_2018_263_Fig1_HTML.png)
![](http://media.springernature.com/m312/springer-static/image/art%3A10.1007%2Fs40292-018-0263-2/MediaObjects/40292_2018_263_Fig2_HTML.png)
Similar content being viewed by others
References
Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension. J Hypertens [Internet]. 2013;31:1281–357. http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00004872-201307000-00002.
Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, 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. Hypertension [Internet]. 2017;HYP.0000000000000065. http://hyper.ahajournals.org/lookup/doi/10.1161/HYP.0000000000000065.
Agabiti-Rosei E, Salvetti M, Farsang C. European Society of Hypertension Scientific Newsletter: treatment of hypertensive urgencies and emergencies. J Hypertens. 2006;24:2482–5.
Zampaglione B, Pascale C, Marchisio M, Cavallo-Perin P. Hypertensive urgencies and emergencies. Prevalence and clinical presentation. Hypertension [Internet]. 1996;27:144–7. http://www.ncbi.nlm.nih.gov/pubmed/8591878.
Katz JN, Gore JM, Amin A, Anderson FA, Dasta JF, Ferguson JJ, et al. Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension: the Studying the Treatment of Acute hyperTension (STAT) Registry. Am Heart J. 2009;158:599–606.
Salvetti M, Paini A, Bertacchini F, Stassaldi D, Aggiusti C, Agabiti Rosei C, et al. Acute blood pressure elevation: therapeutic approach. Pharmacol Res [Internet]. 2018. https://doi.org/10.1016/j.phrs.2018.02.026.
Muiesan ML, Salvetti M, Amadoro V, Di Somma S, Perlini S, Semplicini A, et al. An update on hypertensive emergencies and urgencies. J Cardiovasc Med. 2015;16:372–82.
Lane DA, Lip GYH, Beevers DG. Improving survival of malignant hypertension patients over 40 years. Am J Hypertens [Internet]. 2009;22:1199–204. https://doi.org/10.1038/ajh.2009.153.
Edmunds E, Lip GY. BDG. What has happened to malignant hypertension? A disease no longer vanishing. J Hum Hypertens. 2000;14:171–4.
Tomero E, Alonso S, Laguna P. Hypertensive crises at the hospital emergency services. The SUHCRIHTA study. Emergenicias. 2010;13:82–8.
Cerrilo M, Hernàndez P, Pinilla C, Claros N, Otero M. Hypertensive crises: prevalence and clinical aspects. Rev Clin Esp. 2002;202:255–8.
Vilela Martin JF, Higashiama É, Garcia E, Luizon MR, Cipullo JP. Hypertensive crisis profile. Prevalence and clinical presentation. Arq Bras Cardiol [Internet]. 2004;83:125–36. http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L39159271%5Cn; http://sfxhosted.exlibrisgroup.com/sfxtul?sid=EMBASE&issn=0066782X&id=doi:&atitle=Hypertensive+crisis+profile.+Prevalence+and+clinical+presentation&stitle=Arq.+Bras.+Car.
Vilela-Martin JF, Vaz-De-Melo RO, Kuniyoshi CH, Abdo ANR, Yugar-Toledo JC. Hypertensive crisis: Clinical-epidemiological profile. Hypertens Res. 2011;34:367–71.
Pinna G, Pascale C, Fornengo P, Arras S, Piras C, Panzarasa P, et al. Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study. PLoS One. 2014;9:1–6.
Saguner AM, Dür S, Perrig M, Schiemann U, Stuck AE, Bürgi U, et al. Risk factors promoting hypertensive crises: evidence from a longitudinal study. Am J Hypertens. 2010;23:775–80.
Deshmukh A, Kumar G, Kumar N, Nanchal R, Gobal F, Sakhuja A, et al. Effect of joint national committee VII report on hospitalizations for hypertensive emergencies in the United States. Am J Cardiol. 2011;108:1277–82.
Janke AT, McNaughton CD, Brody AM, Welch RD, Levy PD. Trends in the incidence of hypertensive emergencies in us emergency departments from 2006 to 2013. J Am Heart Assoc. 2016;5:1–8.
Patel KK, Young L, Howell EH, Hu B, Rutecki G, Thomas G, et al. Characteristics and Outcomes of Patients Presenting With Hypertensive Urgency in the Office Setting. JAMA Intern Med [Internet]. 2016;176:981. http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2016.1509.
Vlcek M, Bur A, Woisetschläger C, Herkner H, Laggner AN, Hirschl MM. Association between hypertensive urgencies and subsequent cardiovascular events in patients with hypertension. J Hypertens. 2008;26:657–62.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
All the Authors declare that they have no funding to declare.
Conflict of interest
All the Authors declare that they have no conflict of interest to declare.
Human and animal rights statement
All the Authors declare that this article does not contain any studies with human participants or animals performed by any of the authors.
Additional information
This article is part of the topical collection on Hypertension Urgencies & Emergencies.
Rights and permissions
About this article
Cite this article
Paini, A., Aggiusti, C., Bertacchini, F. et al. Definitions and Epidemiological Aspects of Hypertensive Urgencies and Emergencies. High Blood Press Cardiovasc Prev 25, 241–244 (2018). https://doi.org/10.1007/s40292-018-0263-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40292-018-0263-2