What is the difference between hypertensive emergency and urgency?

While end-organ damage occurs in a hypertensive emergency, a rapid and severe elevation in BP in the absence of organ injury is termed hypertensive urgency.

Why is nicardipine used in hypertensive emergency?

PHOENIX, ARIZ. — Intravenous nicardipine can reduce blood pressure by 15%–20% without impairing blood supply to the brain in hypertensive emergencies, preliminary results from an ongoing case-control study suggest.

Why is nitroprusside used in hypertensive emergency?

Nitroprusside is used predominantly to treat hypertensive emergencies, such as to lower blood pressure during acute aortic dissection or to improve cardiac output in severe congestive heart failure. Nitroprusside is unstable and must be administered intravenously with careful monitoring.

What conditions may trigger a hypertensive emergency or urgency?

Causes of a hypertensive emergency include:

Forgetting to take your blood pressure medication.
Stroke.
Heart attack.
Heart failure.
Kidney failure.
Rupture of your body’s main artery (aorta)
Interaction between medications.
Convulsions during pregnancy (eclampsia)

Which is worse hypertensive urgency or emergency?

Hypertensive urgency must be distinguished from hypertensive emergency. Urgency is defined as severely elevated BP (ie, systolic BP >220 mm Hg or diastolic BP >120 mm Hg) with no evidence of target organ damage. In order to diagnose malignant hypertension, papilledema (see the image below) must be present.

What drug is used in a hypertensive emergency?

The traditional drug of choice for therapy of hypertensive emergencies is sodium nitroprusside. Intravenous labetalol produces a prompt, controlled reduction in blood pressure and is a promising alternative. Other agents used are diazoxide, trimethaphan camsylate, hydralazine, nitroglycerin, and phentolamine.

What is the treatment of hypertensive emergency?

If the blood pressure remains elevated after beta blockade, a vasodilator such as intravenous nitroglycerin or nitroprusside may be administered. The drugs of choice in treating a hypertensive emergency with acute pulmonary edema are intravenous nitroglycerin, clevidipine, or nitroprusside (1,2,5).

What are signs of end organ damage?

The classic manifestations of hypertensive end organ damage include the following: vascular and hemorrhagic stroke, retinopathy, coronary heart disease/myocardial infarction and heart failure, proteinuria and renal failure and in the vasculature, atherosclerotic change including the development of stenoses and …

Which IV fluid is best for hypertension?

Nicardipine, nitroprusside, fenoldopam, nitroglycerin, enalaprilat, hydralazine, labetalol, esmolol, and phentolamine are i.v. antihypertensive agents recommended for use in hypertensive emergency by the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood …

Which is better nicardipine or labetalol for hypertensive patients?

Objective To compare the efficacy of Food and Drug Administration recommended dosing of nicardipine versus labetalol for the management of hypertensive patients with signs and/or symptoms (S/S) suggestive of end-organ damage (EOD). Design Secondary analysis of the multicentre prospective, randomised CLUE trial.

Which is better for renal function nicardipine or nitroprusside?

Fenoldopam, but not nitroprusside, improves renal function in severely hypertensive patients with impaired renal function. Am J Med 1993; 95:161. Peacock WF, Varon J, Baumann BM, et al. CLUE: a randomized comparative effectiveness trial of IV nicardipine versus labetalol use in the emergency department.

Which is the best medication for hypertensive urgencies?

Intravenous nitroglycerin is useful in patients prone to myocardial ischemia, but should be avoided in patients with increased intracranial pressure. Esmolol is effective in controlling both supraventricular tachyarrhythmias and severe hypertension.

When does a hypertensive emergency occur in a patient?

Hypertensive emergency can occur at lower MAPs in previously normotensive patients who have acute hypertension (e.g. pregnant women with preeclampsia). 1 Alternatively, patients with chronic hypertension may have extremely elevated Bp without hypertensive emergency. Myocardial ischemia (type-II myocardial ischemia).

What is the difference between hypertensive emergency and urgency? While end-organ damage occurs in a hypertensive emergency, a rapid and severe elevation in BP in the absence of organ injury is termed hypertensive urgency. Why is nicardipine used in hypertensive emergency? PHOENIX, ARIZ. — Intravenous nicardipine can reduce blood pressure by 15%–20% without impairing blood…