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Control of Blood Pressure in Hypertensive Neurological Emergencies

  • Hypertensive Emergencies (BM Baumann, Section Editor)
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Abstract

Neurological hypertensive emergencies cause significant morbidity and mortality. Most occur in the setting of ischaemic stroke, spontaneous intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH), but other causes relate to hypertensive encephalopathy and reversible cerebral vasoconstriction syndrome (RCVS). Prompt and controlled reduction of blood pressure (BP) is necessary, although there remains uncertainty as to the optimal rate of decline and ideal antihypertensive agent. There is probably no single treatment strategy that covers all neurological hypertensive emergencies. Prompt diagnosis of the underlying disorder, recognition of its severity, and appropriate targeted treatment are required. Lack of comparative-effectiveness data leaves clinicians with limited evidence-based guidance in management, although significant developments have occurred recently in the field. In this article, we review the management of specific neurological hypertensive emergencies, with particular emphasis on recent evidence.

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Authors and Affiliations

  1. Department of Cardiovascular Sciences and NIHR Biomedical Research Unit in Cardiovascular Disease, University of Leicester, Leicester, UK

    Lisa Manning & Thompson G. Robinson

  2. The George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia

    Craig S. Anderson

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  1. Lisa Manning
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  2. Thompson G. Robinson
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  3. Craig S. Anderson
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Correspondence to Craig S. Anderson.

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Conflict of Interest Lisa Manning declares that she has no conflict of interest.

Thompson G. Robinson has received grants from ANHMRC Heath Foundation/The Stroke Association (Grant Funding for INTERACT2 Grant Funding for COSSACS) and The Stroke Association NIHR British Heart Foundation. He has also received advisory board consultancy fees and payments for lectures from Boehringer Ingelhelm. Dr. Robinson has also received paid travel accommodations from Boehringer Ingelhelm, Educational Grant to attend European Stroke Conference).

Craig S. Anderson has received a research fellowship grant from the National Health & Medical Research Council of Australia.

Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Hypertensive Emergencies

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Manning, L., Robinson, T.G. & Anderson, C.S. Control of Blood Pressure in Hypertensive Neurological Emergencies. Curr Hypertens Rep 16, 436 (2014). https://doi.org/10.1007/s11906-014-0436-x

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