Hypertensive Emergencies – Mean Arterial Pressure

For hypertensive emergencies, the aim is to reduce Mean Arterial Pressure (MAP*) by up to 25% in the first hour of treatment. If the patient remains stable with no evidence of organ hypoperfusion, further reductions in the BP towards normal are indicated over the ensuing 24 hours.

Learning-bite

A progressive lowering of BP is indicated in hypertensive emergencies, aiming for an initial reduction in MAP* of ~25% over an hour.

Controlled, progressive reductions in BP are generally achieved with a titratable, intravenous, short-acting antihypertensive agent. This will need to occur in an environment where continuous observation and monitoring of the patient is feasible. These patients will all require admission, ideally to a high dependency unit.
MAP* can be calculated from systolic pressure and diastolic pressure.

Calculation

MAP* = [(2 x diastolic pressure) + systolic pressure] / 3