Hypertensive emergency is having severely elevated blood pressure (>180-220 mmHg/120-130 mmHg) that is complicated by progressive target end-organ damage of the central nervous system, heart, kidneys, or the gravid uterus.
There is no definite blood pressure threshold for the diagnosis of hypertensive emergency.
Most target end-organ damage happen with diastolic blood pressure of ≥130 mmHg.
Hypertensive urgency refers to patients with severely elevated blood pressure (>180/110-120 mmHg) but with little or no evidence of acute end-organ damage.
The clinical differentiation between hypertensive emergencies and urgencies is dependent on the presence of target end-organ damage rather than the level of blood pressure.
Not only does taking antihypertensive drug at bedtime lead to better control of blood pressure (BP), it nearly halves the risk of cardiovascular events compared with dosing upon waking, according to the Hygia Chronotherapy Trial — thus debunking the long-held belief that antihypertensives should be taken in the morning.
The lower threshold for hypertension diagnosis in the 2017 ACC/AHA hypertension guidelines does not necessarily entail more pharmacological treatment, says a leading expert in cardiology during a presentation at AFCC 2018, who highlights that the first key step for managing hypertension is lifestyle modification.
While intensive treatment of hypertension may benefit patients with a higher risk for cardiovascular disease (CVD), it may do more harm than good for those with a lower CVD risk, reveals a stratified analysis of the SPRINT* study.
Self-monitoring of blood pressure (BP), when used by general practitioners (GPs) to titrate antihypertensive therapy, led to significantly lower BP in people with poorly controlled BP than titration guided by clinic BP readings, the TASMINH4* study finds.
A polypill containing fixed low doses of three antihypertensive drugs led to better blood pressure (BP) control without increased adverse effects compared with usual care among people with persistent hypertension, according to the TRIUMPH* trial.
Blood pressure (BP) readings appeared to be similar regardless of whether BP measurements were attended or unattended by staff, nor were CV outcomes different between the two techniques, according to a post hoc survey on participants following the SPRINT* trial.
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