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Modern Management of Hypertensive Emergencies

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Abstract

Acute increases of blood pressure values are common causes of patients’ presentation to emergency departments, and their management represents a clinical challenge. They are usually described as ‘hypertensive crises’, ‘hypertensive urgencies’, terms that should be abandoned because they are misleading and inappropriate according to a recent task force of the European Society of Cardiology, which recommended to focus only on ‘hypertensive emergencies’. The latter can be esasily identified by using the Brain, Arteries, Retina, Kidney, and/or Heart (BARKH) strategy as herein described. Although current guidelines recommendations/suggestions for treatment of these patients are not evidence-based, owing to the lack of randomized clinical trials, improved understanding of the underlying pathophysiology has changed the approach to management of the patients presenting with hypertensive emergencies in recent years. Starting from these premises and a systematic review of the available studies graded by their quality, using the AHA class of recommendation/level of evidence grading, whenever possible, we herein present a novel a streamlined symptoms- and evidence-based algorithm for the assessment and management of patients with hypertensive emergencies.

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Authors and Affiliations

  1. Department of Medicine-DIMED, University of Padua, Padua, Italy

    Gian Paolo Rossi, Giacomo Rossitto, Chiarastella Maifredini, Agatella Barchitta, Andrea Bettella, Lorenzo Cerruti, Raffaele Latella, Luisa Ruzza, Beatrice Sabini, Stefania Vigolo & Teresa M. Seccia

  2. Emergencies and Hypertension Unit, University Hospital, Padua, Italy

    Gian Paolo Rossi, Giacomo Rossitto & Teresa M. Seccia

Authors
  1. Gian Paolo Rossi
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  2. Giacomo Rossitto
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  3. Chiarastella Maifredini
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  4. Agatella Barchitta
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  5. Andrea Bettella
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  6. Lorenzo Cerruti
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  8. Luisa Ruzza
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  10. Stefania Vigolo
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  11. Teresa M. Seccia
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Corresponding author

Correspondence to Gian Paolo Rossi.

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Sources of funding

This study was supported by the following Grants: European Cooperation in Science and Technology ADMIRE BM1301, European Cooperation in Science and Technology ENSAT-HT 633983 to GPR, Italian Society of Hypertension (SIIA), and FORICA (The Foundation for advanced Research In Hypertension and Cardiovascular diseases) to GPR, and University of Padua DOR2045593/20 to TMS.

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The authors have nothing to disclose.

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Rossi, G.P., Rossitto, G., Maifredini, C. et al. Modern Management of Hypertensive Emergencies. High Blood Press Cardiovasc Prev 29, 33–40 (2022). https://doi.org/10.1007/s40292-021-00487-1

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  • DOI: https://doi.org/10.1007/s40292-021-00487-1

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