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.


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 calculatedĀ from systolic pressure and diastolic pressure.


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