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 in | The New England journal of medicine Vol. 382; no. 7; p. e11 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Massachusetts Medical Society
13.02.2020
|
| Subjects | |
| Online Access | Get full text |
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| Abstract | 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 . . . |
|---|---|
| AbstractList | 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 . . . 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 pressure6 and unnecessary referrals to the emergency department from primary care physicians.4 Evidence is lacking to show that minor symptoms, including . . . |
| Author | Parmar, Malvinder S Peixoto, Aldo J Sibley, Aaron Gosse, Philippe Rubin, Sébastien Shayne, Philip Combe, Christian |
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| References | 32053318 - N Engl J Med. 2020 Feb 13;382(7):e11 31693807 - N Engl J Med. 2019 Nov 7;381(19):1843-1852 e_1_2_3_2_4_2 e_1_2_3_2_6_2 Whelton PK (e_1_2_3_2_3_2) 2018; 71 e_1_2_3_2_5_2 e_1_3_3_2_3_2 e_1_2_3_2_7_2 e_1_3_3_2_2_2 e_1_3_3_2_5_2 e_1_3_3_2_4_2 Whelton PK (e_1_5_3_2_2_2) 2018; 71 e_1_2_3_2_2_2 Headache Classification Committee of the International Headache Society (IHS) (e_1_5_3_2_3_2) 2018 e_1_4_3_2_3_2 e_1_5_3_2_6_2 e_1_4_3_2_4_2 e_1_5_3_2_4_2 e_1_4_3_2_2_2 e_1_5_3_2_5_2 |
| References_xml | – ident: e_1_4_3_2_3_2 doi: 10.1016/j.amjhyper.2005.03.728 – ident: e_1_2_3_2_4_2 doi: 10.1016/j.annemergmed.2013.05.012 – ident: e_1_4_3_2_2_2 doi: 10.1001/jamainternmed.2019.1455 – volume: 71 start-page: e13 issue: 6 year: 2018 ident: e_1_5_3_2_2_2 article-title: 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. publication-title: Hypertension contributor: fullname: Whelton PK – ident: e_1_5_3_2_6_2 doi: 10.1007/s11906-018-0818-6 – ident: e_1_3_3_2_3_2 doi: 10.1016/j.amjhyper.2007.02.018 – ident: e_1_2_3_2_2_2 doi: 10.1056/NEJMcp1901117 – ident: e_1_3_3_2_4_2 doi: 10.1097/HJH.0000000000001913 – ident: e_1_5_3_2_5_2 doi: 10.1093/ehjcvp/pvy032 – ident: e_1_2_3_2_5_2 doi: 10.1001/jamainternmed.2016.1509 – ident: e_1_2_3_2_6_2 doi: 10.1016/j.ajem.2015.05.036 – ident: e_1_3_3_2_2_2 doi: 10.1016/j.ahj.2009.07.020 – volume: 71 start-page: e13 issue: 6 year: 2018 ident: e_1_2_3_2_3_2 article-title: 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. publication-title: Hypertension contributor: fullname: Whelton PK – ident: e_1_4_3_2_4_2 doi: 10.1111/j.1751-7176.2011.00476.x – start-page: 1 volume-title: Cephalalgia year: 2018 ident: e_1_5_3_2_3_2 contributor: fullname: Headache Classification Committee of the International Headache Society (IHS) – ident: e_1_3_3_2_5_2 doi: 10.1093/ehjcvp/pvy032 – ident: e_1_2_3_2_7_2 doi: 10.1111/jch.12765 – ident: e_1_5_3_2_4_2 doi: 10.1097/HJH.0000000000001913 |
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| Snippet | To the Editor:
In his Clinical Practice article, Peixoto (Nov. 7 issue)
1
recommends immediate lowering of blood pressure in patients who present with... To the Editor: In his Clinical Practice article, Peixoto (Nov. 7 issue)1 recommends immediate lowering of blood pressure in patients who present with... |
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| SubjectTerms | Antihypertensive Agents Blood pressure Emergency medical care Humans Hypertension Primary care |
| Title | Acute Severe Hypertension |
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