Acute Severe Hypertension

To the Editor: In his Clinical Practice article, Peixoto (Nov. 7 issue) 1 recommends immediate lowering of blood pressure in patients who present with “hypertensive urgency” (acute severe hypertension without acute target-organ damage). We are concerned that this recommendation is not consistent wit...

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Published inThe New England journal of medicine Vol. 382; no. 7; p. e11
Main Authors Sibley, Aaron, Shayne, Philip, Rubin, Sébastien, Combe, Christian, Gosse, Philippe, Parmar, Malvinder S, Peixoto, Aldo J
Format Journal Article
LanguageEnglish
Published United States Massachusetts Medical Society 13.02.2020
Subjects
Antihypertensive Agents
Blood pressure
Emergency medical care
Humans
Hypertension
Primary care
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Summary:To the Editor: In his Clinical Practice article, Peixoto (Nov. 7 issue) 1 recommends immediate lowering of blood pressure in patients who present with “hypertensive urgency” (acute severe hypertension without acute target-organ damage). We are concerned that this recommendation is not consistent with current emergency medicine practice. 2,3 This approach has not been shown to reduce adverse short-term outcomes, including repeat visits to the emergency department, major adverse cardiovascular events, and death, 4,5 but it may result in unpredictable changes in blood pressure 6 and unnecessary referrals to the emergency department from primary care physicians. 4 Evidence is lacking to show that minor symptoms, including . . .
Bibliography:SourceType-Other Sources-1
content type line 63
ObjectType-Correspondence-1
ObjectType-Commentary-2
ISSN:0028-4793
1533-4406
DOI:10.1056/NEJMc1916851