Hypertensive Emergencies
A Hypertensive emergency is any elevation in blood pressure in the presence of end-organ dysfunction. Aggressively treating severe asymptomatic hypertension (very high blood pressure without clear end organ damage) is not indicated, not supported by the literature and DANGEROUS. First, do no harm.
2020 International Society of Hypertension Global Hypertension Practice Guidelines
In accordance with most major guidelines it is recommended that hypertension be diagnosed when a person’s systolic blood pressure (SBP) in the office or clinic is ≥140 mm Hg and/or their diastolic blood pressure (DBP) is ≥90 mm Hg following repeated examination.
The Silent Killer
Today, cardiovascular disease is the number-one cause of death in sub-Saharan Africa in adults over the age of 30.
Shut up during triage or end up on antihypertensives (learnt this from one of our nurses today)
10 Factors That Can Affect Blood Pressure Readings Blood Pressure Cuff is too Small… Blood Pressure Cuff Used Over Clothing Not Resting 3-5 minutes Arm/Back/Feet Unsupported Emotional State Talking Smoking Alcohol/Caffeine Temperature Full bladder
BP 252/130…start IV Fluids…this won’t blow up the patient…
The diagnosis of hypertensive emergency is made based upon the findings of hypertension in the setting of end-organ damage (usually heart, brain, or kidneys). What you really care about is the rate of increase rather than the actual BP number (there is no defining threshold).
