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Hypertension urgency emergency

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https://www.readbyqxmd.com/read/29541933/clinical-characteristics-of-black-patients-with-hypertensive-urgency
#1
Robert Munashe Maweni, Nicholas Sunderland, Zahra Rahim, Emmanuella Odih, Jins Kallampallil, Thomas Saunders, Srikanth Akunuri
BACKGROUND: Hypertensive urgency is defined as a severely elevated systolic blood pressure (SBP) of ≥ 180 mmHg and/or diastolic blood pressure (DBP) of ≥ 120 mmHg, in the absence of end organ damage. It is known that there are racial differences in prevalence and severity of hypertension but there is a dearth of studies looking at hypertensive urgency in Black populations living in Europe. AIMS: We sought to define the clinical characteristics of Black patients presenting with hypertensive urgency, in order to better define the risks and complications this growing population of patients faces...
March 14, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29490381/-hypertensive-crisis-and-posterior-reversible-encephalopathy-syndrome-pres
#2
Olaf Eberhardt
The urgency and intensity of therapeutic response to a hypertensive crisis are governed by the presence or absence of acute end-organ damage, which define hypertensive emergency and hypertensive urgency, respectively. In case of hypertensive urgency a slow and moderate lowering of blood pressure by oral antihypertensive agents seems adequate, while the approach to hypertensive emergency has to be tailored to the specific type of organ failure. Optimal blood pressure management in the context of neurovascular emergencies is made difficult by contradictory data from observational and interventional studies...
February 28, 2018: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/29482197/overtreatment-of-asymptomatic-hypertension-urgency-is-not-an-emergency-a-teachable-moment
#3
Jeong Yun Yang, Sophia Chiu, Mona Krouss
No abstract text is available yet for this article.
February 26, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29481963/acute-blood-pressure-elevation-therapeutic-approach
#4
REVIEW
Massimo Salvetti, Anna Paini, Fabio Bertacchini, Deborah Stassaldi, Carlo Aggiusti, Claudia Agabiti Rosei, Maria Lorenza Muiesan
International guidelines have suggested to avoid the term "hypertensive crisis" for the description of an acute and severe increase in blood pressure (BP) and to consider the definition of 'hypertensive emergencies' or 'hypertensive urgencies'. These two clinical presentations are characterized by the presence of high BP values but imply a different diagnostic and therapeutic approach. Hypertension awareness, treatment and control are slightly increased in the last years mostly in the United States and in some European nations...
February 23, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29340938/pharmacologic-treatment-of-hypertensive-urgency-in-the-outpatient-setting-a-systematic-review
#5
Claudia L Campos, Charles T Herring, Asima N Ali, Deanna N Jones, James L Wofford, Augustus L Caine, Robert L Bloomfield, Janine Tillett, Karen S Oles
BACKGROUND: Hypertensive urgency (HU), defined as acute severe uncontrolled hypertension without end-organ damage, is a common condition. Despite its association with long-term morbidity and mortality, guidance regarding immediate management is sparse. Our objective was to summarize the evidence examining the effects of antihypertensive medications to treat. METHODS: We searched the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Cochrane Database of Systematic Reviews, Web of Science, Google Scholar, and Embase through May 2016...
January 16, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29205506/systematic-review-and-meta-analysis-on-the-efficacy-and-tolerability-of-mirabegron-for-the-treatment-of-storage-lower-urinary-tract-symptoms-overactive-bladder-comparison-with-placebo-and-tolterodine
#6
REVIEW
Arcangelo Sebastianelli, Giorgio I Russo, Steven A Kaplan, Kevin T McVary, Ignacio Moncada, Stavros Gravas, Christopher Chapple, Giuseppe Morgia, Sergio Serni, Mauro Gacci
A systematic review and meta-analysis was carried out to evaluate the efficacy and safety of mirabegron 50 mg and 100 mg in the treatment of storage lower urinary tract symptoms/overactive bladder in comparison with a placebo and tolterodine 4 mg. A total of 491 articles were collected and eight randomized studies were identified as eligible for this meta-analysis. Overall, eight trials were included in the meta-analysis evaluating 10 248 patients. Mirabegron at both doses of 50 mg and 100 mg, and and tolterodine 4 mg were significantly associated with the reduction of incontinence episodes per 24 h, reduction of mean number of micturitions per 24 h, increase of voided volume and reduction of urgency episodes per 24 h, compared to a placebo...
December 3, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/29174704/diagnostic-and-therapeutic-approach-to-the-hypertensive-crisis
#7
REVIEW
Guillermo Arbe, Irene Pastor, Jonathan Franco
High blood pressure is a problem with elevated prevalence in the world population. The acute forms of presentation are "hypertensive crises," which represent a frequent cause for emergency room and primary care consultations. Hypertensive crises are divided into hypertensive emergencies and hypertensive urgencies, depending on whether or not there is acute damage to the target organ, respectively. Each situation has a different prognosis and treatment. More specifically, hypertensive emergencies are potentially serious and usually require rapid reductions in blood pressure, whereas hypertensive urgencies can be treated as outpatients by reducing blood pressure in hours or days...
April 23, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29097857/like-the-eye-of-the-tiger-inpatient-psychiatric-facility-exclusionary-criteria-and-its-knockout-of-the-emergency-psychiatric-patient
#8
Veronica Tucci, John Liu, Anu Matorin, Asim Shah, Nidal Moukaddam
Context: Over 6% of all emergency department (ED) visits in the United States involve primary mental health or behavioral issues. The patients are stabilized in the ED but frequently require admission to an inpatient psychiatric unit or institution for longer term treatment and management. To facilitate this process, an emergency physician (EP) must first "medically clear" the patient as stable for transfer. At present, there is no interdisciplinary consensus regarding the necessary elements of the medical clearance or stability assessment process...
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28976377/-hypertension-in-the-elderly
#9
Filiz Özerkan Çakan
Hypertension (HT) is a common problem in elderly persons (age >65 years), reaching a prevalence as high as 60 to 80%. Isolated systolic HT mostly occurs in older patients. Treatment of HT in all patients, independent of age, consists of lifestyle modifications and antihypertensive therapy. Randomized trials have provided clear evidence of benefit from treating HT in elderly patients, including those over the age of 80 years. Drug therapy should be started in elderly hypertensive patients if lifestyle changes are insufficient and in the absence of a hypertensive emergency or urgency, blood pressure reduction should always be gradual...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28938507/-hypertensive-emergencies
#10
Gerd Bönner
Hypertensive urgency and hypertensive emergency are associated with sudden, massive rise in blood pressure. An acute increase in blood pressure to values above 180/120 mmHg is considered critical. If not treated in time, it can quickly enter a life-threatening hypertensive emergency. The symptoms or organ damage determine the assessment as a crisis or an emergency. Rapid action is required. The therapy depends on the severity and the organ involvement. However the general principal is to avoid therapeutically induced hypotension...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28927394/laboratory-markers-of-cardiac-and-metabolic-complications-after-generalized-tonic-clonic-seizures
#11
Robert D Nass, Sina Meiling, René P Andrié, Christian E Elger, Rainer Surges
BACKGROUND: Generalized tonic-clonic seizures (GTCS) frequently lead to emergency inpatient referrals. Laboratory blood values are routinely performed on admission to detect underlying causes and metabolic or cardiac complications. Our goal was to assess the nature and frequency of complications occurring in association with GTCS. METHODS: We retrospectively extracted data from emergency protocols and discharge letters of adult patients admitted to the Department of Epileptology between 01/2010 and 06/2015...
September 19, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28866866/hospital-and-out-of-hospital-mortality-in-670-hypertensive-emergencies-and-urgencies
#12
Haythem Guiga, Clémentine Decroux, Pierre Michelet, Anderson Loundou, Dimitri Cornand, François Silhol, Bernard Vaisse, Gabrielle Sarlon-Bartoli
Long-term mortality in patients with acute severe hypertension is unclear. The authors aimed to compare short-term (hospital) and long-term (12 months) mortality in these patients. A total of 670 adults presenting for acute severe hypertension between January 1, 2015, and December 31, 2015, were included. A total of 57.5% were hypertensive emergencies and 66.1% were hospitalized: 98% and 23.2% of those with hypertensive emergencies and urgencies, respectively (P = .001). Hospital mortality was 7.9% and was significantly higher for hypertensive emergencies (12...
November 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28807040/management-of-upper-gastrointestinal-bleeding-in-emergency-departments-from-bleeding-symptoms-to-diagnosis-a-prospective-multicenter-observational-study
#13
Pierre-Clément Thiebaud, Youri Yordanov, Jacques-Emmanuel Galimard, Pierre-Alexis Raynal, Sébastien Beaune, Laurent Jacquin, François-Xavier Ageron, Dominique Pateron
BACKGROUND: Upper gastrointestinal bleeding (UGB) is common in emergency departments (EDs) and can be caused by many eso-gastro-duodenal lesions. Most available epidemiological data and data on the management of UGB comes from specialized departments (intensive care units or gastroenterology departments), but little is known from the ED perspective. We aimed to determine the distribution of symptoms revealing UGB in EDs and the hemorrhagic lesions identified by endoscopy. We also describe the characteristics of patients consulting for UGB, UGB management in the ED and patients outcomes...
August 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28782308/a-prospective-observational-study-to-determine-the-prevalence-and-clinical-profile-of-patients-of-hypertensive-crisis-in-a-tertiary-care-hospital
#14
Santosh B Salagre, Shobha M Itolikar, Kapil Gedam
BACKGROUND: Hypertension can present in crisis form as 'hypertensive urgency'(HU) or as 'hypertensive emergency' (HE). Both the conditions are associated with significant morbidity and mortality. AIM: To evaluate the clinical characteristics, course of illness, end-organ damage and survival outcome in patients with hypertensive crisis. METHODOLOGY: This prospective observational year-long study was conducted after due ethical considerations on 120 adult non-pregnant patients who presented with blood pressure of >180/120 mm Hg in the emergency medical services of a tertiary care hospital...
June 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28692167/modern-management-of-hypertensive-emergencies-and-urgencies-do-we-need-more-technology-paramedics-or-physicians
#15
Kyriakos Dimitriadis, Costas Tsioufis, Dimitris Tousoulis
No abstract text is available yet for this article.
July 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28655201/unplanned-reoperation-after-craniotomy-for-tumor-a-national-surgical-quality-improvement-program-analysis
#16
Hormuzdiyar H Dasenbrock, Sandra C Yan, Vamsi Chavakula, William B Gormley, Timothy R Smith, Elizabeth B Claus, Ian F Dunn
BACKGROUND: Reoperation has been increasingly utilized as a metric evaluating quality of care. OBJECTIVE: To evaluate the rate of, reasons for, and predictors of unplanned reoperation after craniotomy for tumor in a nationally accrued population. METHODS: Patients who underwent cranial tumor resection were extracted from the prospective National Surgical Quality Improvement Program registry (2012-2014). Multivariate logistic regression examined predictors of unplanned cranial reoperation...
November 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28569557/effects-of-acute-blood-pressure-elevation-on-biochemical-metabolic-parameters-in-individuals-with-hypertensive-crisis
#17
Days Oliveira Andrade, Sara Patrícia O Santos, Marcela Augusta S Pinhel, Flávia Mariana Valente, Marcela Cavichiolo Giannini, Michele Lima Gregório, Moacir Fernandes De Godoy, Dorotéia Rossi S Souza, José Fernando Vilela-Martin
Hypertensive crisis is a common clinical situation that presents a high rate of morbidity and mortality and it is characterized by symptomatic rise of blood pressure (BP), systolic (SBP) ≥ 180 mmHg and/or diastolic (DBP) ≥ 120 mmHg. It is classified as emergency (HE) or hypertensive urgency (HU). There is no description of laboratory findings in patients who present acute BP elevation. Thus, this study had the objective to assess the biochemical-metabolic parameters of patients with HC. We studied 74 normotensive individuals (NT), 74 controlled hypertensive patients (ContrHT), 50 subjects with HU, and 78 with HE for evaluating biochemical-metabolic parameters...
2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28560799/blood-pressure-management-and-guideline-adherence-in-hypertensive-emergencies-and-urgencies-a-comparison-between-telemedically-supported-and-conventional-out-of-hospital-care
#18
COMPARATIVE STUDY
Jörg C Brokmann, Rolf Rossaint, Michael Müller, Christina Fitzner, Luigi Villa, Stefan K Beckers, Sebastian Bergrath
Prehospital hypertensive emergencies and urgencies are common, but evidence is lacking. Telemedically supported hypertensive emergencies and urgencies were prospectively collected (April 2014-March 2015) and compared retrospectively with a historical control group of on-scene physician care in the emergency medical service of Aachen, Germany. Blood pressure management and guideline adherence were evaluated. Telemedical (n=159) vs conventional (n=172) cases: blood pressure reductions of 35±24 mm Hg vs 44±23 mm Hg revealed a group effect adjusted for baseline differences (P=...
July 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28414672/a-strong-and-fortuitous-case-of-dyspnea
#19
R Hammer, M Sciaudone
CASE: A 48 year-old man with no past medical history was sent to our emergency department (ED); from a primary care clinic for hypertensive urgency of 200/130. The man reported an intermittent non-productive cough of approximately one year's duration and worsening dyspnea on exertion and orthopnea over the last month with lower extremity swelling. Of note, he emigrated from Honduras twenty years ago. Blood pressure normalized with administration of Lasix in the ED. Physical exam revealed rales in lung bases bilaterally, jugular venous distension, lower extremity pitting edema with serpiginous patches of erythema and excoriation, and a cardiac gallop...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28306673/hypertensive-crisis-an-update-on-clinical-approach-and-management
#20
Emrah Ipek, Ahmet Afşin Oktay, Selim R Krim
PURPOSE OF REVIEW: Here, we review current concepts on hypertensive crisis (HTN-C) with a focus on epidemiology, causes, pathophysiology and prognosis. We also offer a practical approach to the management of HTN-C. RECENT FINDINGS: HTN-C is characterized by a severe and abrupt increase in blood pressure (BP) with impending or progressive acute end-organ damage (EOD). HTN-C can be divided into hypertensive emergency (HTN-E) and hypertensive urgency (HTN-U) based on the presence or absence of acute EOD, respectively...
July 2017: Current Opinion in Cardiology
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