Identifying a Hypertensive Emergency

The emergency physician must be able to differentiate a true hypertensive emergency from ‘other conditions’ presenting with an elevated BP (hypertensive urgencies), so that appropriate decisions about BP control can be made.

In particular, the need to rapidly control elevated BP must be balanced by the potential to compromise organ perfusion.

Once significant elevation of BP is confirmed, the clinical assessment is primarily directed at establishing whether there is evidence of acute or progressive end organ damage, with emphasis on the cardiovascular, renal and central neurological systems.