Key Points in High BP management:
- Don’t get worried with numbers, treat only if the patient is symptomatic. Asymptomatic HTN goes home with good follow up/discharge instructions.
- High BP + end organ damage is HTN emergency, again don’t look at specific numbers to call it HTN emergency.
- Reduce MAP by 20-25% in the first hour with titratable IV meds (Exception dissection, eclampsia where you need to get down as quickly as possible)
- Most of them are fluid depleted and need IV fluids, which also prevents the sudden drop in pressures after commencing IV therapy.
- NTG drip is not the answer to everything!