Hypertensive urgency is a type of hypertensive emergency in which the patient has very high blood pressure but very few, if any, symptoms. Unlike malignant hypertension, there are no acute signs of end-organ damage. Up to Date notes that hypertensive urgency occurs most frequently among patients who have been non-compliant with their blood pressure regime or who have ingested a large quantity of salt.
Initial Assessment
The Cleveland Clinic stresses the importance of asking the patient about all prescription and recreational drugs. It suggests that doctors ask patients directly whether they have been compliant with hypertension regimes. Obtaining information about other chronic conditions is also important because it can provide clues as to which organs are at risk of damage.
Medication
The Journal of the American Academy of Physician Assistants lists a variety of drugs that can be used to treat hypertensive emergency. Possible pharmacological treatments include calcium channel blockers such as amlodipine, ACE inhibitors such as captopril, alpha-agonists such as clonidine and diuretics such as lasix. Labetalol and nicaropine can also be helpful. These drugs are given orally rather than intravenously.
Hospitalization
Generally, hypertensive urgency is treated in the emergency room. The patient is generally monitor for a few hours and given oral medical before release. The Journal for the American Academy of Physician Assistants and Up to Date emphasize the importance of follow-up--preferably within two to four days.
