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Focused Update on Pharmacologic Management of Hypertensive Emergencies

  • Antihypertensive Agents: Mechanisms of Drug Action (ME Ernst, Section Editor)
  • Published:
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Abstract

Purpose of Review

Hypertensive emergency is defined as a systolic blood pressure > 180 mmHg or a diastolic blood pressure > 120 mmHg with evidence of new or progressive end-organ damage. The purpose of this paper is to review advances in the treatment of hypertensive emergencies within the last 5 years.

Recent Findings

New literature and recommendations for managing hypertensive emergencies in the setting of pregnancy, stroke, and heart failure have been published.

Summary

Oral nifedipine is now considered an alternative first-line therapy, along with intravenous hydralazine and labetalol for women presenting with pre-eclampsia. Clevidipine is now endorsed by guidelines as a first-line treatment option for blood pressure reduction in acute ischemic stroke and may be considered for use in intracranial hemorrhage. Treatment of hypertensive heart failure remains challenging; clevidipine and enalaprilat can be considered for use in this population although data supporting their use remains limited.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. University of Maryland School of Pharmacy, 20 N Pine Street, Baltimore, MD, 21201, USA

    Kristin Watson, Rachael Broscious, Sandeep Devabhakthuni & Zachary R. Noel

  2. ATRIUM Cardiology Collaborative, Baltimore, MD, USA

    Kristin Watson, Sandeep Devabhakthuni & Zachary R. Noel

Authors
  1. Kristin Watson
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  2. Rachael Broscious
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  3. Sandeep Devabhakthuni
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  4. Zachary R. Noel
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Correspondence to Kristin Watson.

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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 Antihypertensive Agents: Mechanisms of Drug Action

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Watson, K., Broscious, R., Devabhakthuni, S. et al. Focused Update on Pharmacologic Management of Hypertensive Emergencies. Curr Hypertens Rep 20, 56 (2018). https://doi.org/10.1007/s11906-018-0854-2

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  • DOI: https://doi.org/10.1007/s11906-018-0854-2

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