How to Tell Uncontrolled Hypertension and Hypertensive Emergencies Apart

It is not an uncommon sight to find patients with hypertension presenting to the Emergency Department. Did you know that one in four Canadians is diagnosed with it? Chronic hypertension is also the leading cause of disability-adjusted life expectancy.

Hypertensive Emergencies

Heterogenous acute hypertensive disorders make up hypertensive emergencies. These afflictions require immediate diagnosis and treatment. Using the main guidelines used in the country, we can break down hypertensive emergencies into two groups:

  • Evidence of worsening or acute end-organ damage
  • Severe hypertension (dBP > 120-130 and/or sBP > 180)

We will discuss the difference between these two in the next section.

The Difference Between The Two

Patients who do not have acute hypertension-mediated end-organ damage are not considered to have a hypertensive emergency. Instead, they simply have uncontrolled hypertension. The use of “hypertensive urgency” as a term simply refers to this. Kindly note that it is not considered its own entity.

Subtle cases of genuine hypertensive emergencies are composed of hypertensive nephropathy, encephalopathy, and retinopathy. They are considered “grey” zone cases. It is important to learn more about these as it is easy to miss the signs. Early identification and urgent treatment will benefit the patient.

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