hrvatski

Hipertenzivna emergencija i urgencija

Hypertension is one of the most common chronic global diseases today. A sudden rise in blood pressure (BP) in a person with or without a diagnosis of hypertension is called a hypertensive crisis. Hypertensive crisis is defined by systolic blood pressure (SBP) greater than 180 mm / Hg and / or diastolic blood pressure (DBP) greater than 120 mm / Hg. The most common causes of hypertensive crisis are considered to be edication noncompliance, renovascular diseases (renal artery stenosis, polyarteritis nodosa, and Takayasu arteritis), renal parenchymal disease (glomerulonephritis, tubulointerstitial nephritis, systemic sclerosis, hemolytic-uremic erectile syndrome, systemic lupus dysfunction). (pheochromocytoma, Cushing disease, primary hyperaldosteronism, renin- secreting tumor), coarctation of aorta, drugs or other exposures, including cocaine, amphetamines, phencyclidine, sympathomimetics, erythropoietin, cyclosporine, antihypertensive medication withdrawal and central nervous system disorders , cerebral infarction, and cerebral hemorrhage. The crisis is most often manifested by headache (22%), epistaxis (17%), fainting and psychomotor agitation (10%), chest pain (27%), dyspnea (22%) and neurological deficit (21%). If there is no damage to target organs such as the brain, heart and kidneys, we are talking about hypertensive urgency. If there is acute irreversible hypertension-mediated organ damage (HMOD) to the target organs, we are talking about hypertensive emergency. Rapid management of a hypertensive crisis reduces the risks of acute damage to target organs such as cerebral infarction (24%), acute pulmonary edema (23%), hypertensive encephalopathy (16%) and cerebral hemorrhage (4.5%). The most important factor that reduces morbidity and mortality is the timely application of adequate therapy. Hypertensive emergency requires outpatient treatment with oral antihypertensives (calcium channel blockers, beta blockers), while hypertensive emergency requires admission to the intensive care unit (ICU) for immediate reduction of blood pressure with intravenous short-acting antihypertensive drugs that can be titrated (labetalol, esmolol, nicardipine and sodium nitroprusside). The choice of drug depends on the type of damage to the organ, pharmacokinetics and concomitant diseases. Mean arterial pressure (MAP) should decrease by approximately 10 to 20% over the first hour and by an additional 5% to 15% over the next 24 hours.

hipertenzivna kriza, hipertenzivna emergencija, hipertenzivna urgencija

nije evidentirano

engleski

Hypertensive emergency and urgency

Hypertension is one of the most common chronic global diseases today. A sudden rise in blood pressure (BP) in a person with or without a diagnosis of hypertension is called a hypertensive crisis. Hypertensive crisis is defined by systolic blood pressure (SBP) greater than 180 mm / Hg and / or diastolic blood pressure (DBP) greater than 120 mm / Hg. The most common causes of hypertensive crisis are considered to be edication noncompliance, renovascular diseases (renal artery stenosis, polyarteritis nodosa, and Takayasu arteritis), renal parenchymal disease (glomerulonephritis, tubulointerstitial nephritis, systemic sclerosis, hemolytic-uremic erectile syndrome, systemic lupus dysfunction). (pheochromocytoma, Cushing disease, primary hyperaldosteronism, renin- secreting tumor), coarctation of aorta, drugs or other exposures, including cocaine, amphetamines, phencyclidine, sympathomimetics, erythropoietin, cyclosporine, antihypertensive medication withdrawal and central nervous system disorders , cerebral infarction, and cerebral hemorrhage. The crisis is most often manifested by headache (22%), epistaxis (17%), fainting and psychomotor agitation (10%), chest pain (27%), dyspnea (22%) and neurological deficit (21%). If there is no damage to target organs such as the brain, heart and kidneys, we are talking about hypertensive urgency. If there is acute irreversible hypertension-mediated organ damage (HMOD) to the target organs, we are talking about hypertensive emergency. Rapid management of a hypertensive crisis reduces the risks of acute damage to target organs such as cerebral infarction (24%), acute pulmonary edema (23%), hypertensive encephalopathy (16%) and cerebral hemorrhage (4.5%). The most important factor that reduces morbidity and mortality is the timely application of adequate therapy. Hypertensive emergency requires outpatient treatment with oral antihypertensives (calcium channel blockers, beta blockers), while hypertensive emergency requires admission to the intensive care unit (ICU) for immediate reduction of blood pressure with intravenous short-acting antihypertensive drugs that can be titrated (labetalol, esmolol, nicardipine and sodium nitroprusside). The choice of drug depends on the type of damage to the organ, pharmacokinetics and concomitant diseases. Mean arterial pressure (MAP) should decrease by approximately 10 to 20% over the first hour and by an additional 5% to 15% over the next 24 hours.

hypertensive crisis, hypertensive emergency, hypertensive urgency

nije evidentirano