Introduction

Systemic Hypertension is a common medical condition affecting over 1 billion people worldwide¹. Among the population considered, the prevalence is found to be 24%,for which the people are affected with hypertension. The significant mortality affecting cardiovascular, cerebrovascular and renal is mainly due to hypertension and its emergencies. The treatment strategies focussed on hypertension are mostly associated with the urgency and emergency. A hypertensive emergency is characterized by rapid deterioration of target-organs and poses an immediate threat to life. The reduction in mortality of hypertension emergencies is associated with focus on the early detection of end organ damage caused due to factors leading from hypoertension.

This study provides a view on hypertensive emergencies, focusing on one of its most serious complications: hypertensive emergency; a serious condition in which blood pressure undergoes an elevation >180/120 mm Hg, and is associated with end organ dysfunction (e.g. heart, kidneys, eyes or brain). The most common clinical presentations of hypertensive emergencies are cerebral infarction (24.5%), pulmonary edema (22.5%), hypertensive encephalopathy (16.3%) and congestive heart failure(12%). other clinical presentations associated with hypertensive emergencies include intracranial haemorrhage, aortic dissection and eclampsia.

1. Rosen Cj. Vitamin D Insufficiency, N Engl j med 2011;364;248-254 Bruno
2. Zampglione, Claudio pascale, hypertension 1996;27:144-147
3. Joint national committee on prevention detection and treatment of high blood pressure. The seventh report of Joint national committee on prevention detection, and treatment of high blood pressure. JAMA 2003; 289: 2560-2572.
4. Zamapaglione et al. Hypertensive urgencies and emergencies. Hypertension 1996; 27: 144-147.
5. Deshmukh A, Kumar G, Kumar N, et al. Effect of Joint National Committee VII report on hospitalizations for hypertensive emergencies in the United States. Am J Cardiol. 2011; 108(9): 1277–82. [PubMed: 21890093]
6. Sanjay Gulhane et al, Study f Clinical Profile Of Patients wth Urgencies And Emergencies Iosr Journal Of Dental And Medical Sciences.Volume 15 Issue62016 June 24-29
7. Martin J et al: ArquivosBrasileiros de Cardiologia - Volume 83, August 2004
8. Froehlich RJ, Maggio L, Has P, Vrees R, Hughes BL. Improving Obstetric Hypertensive Emergency Treatment in a Tertiary Care Women's Emergency Department. Obstet Gynecol. 2018 Oct;132 (4):850-858. 
9. Shao PJ, Sawe HR, Murray BL, Mfinanga JA, Mwafongo V, Runyon MS. Profile of patients with hypertensive urgency and emergency presenting to an urban emergency department of tertiary referral hospital in Tanzania. BMC Cardiovasc Disord. 2018 Aug 02;18(1)
10. Tocci G, Figliuzzi I, Presta V, Miceli F, Citoni B, Coluccia R, Musumeci MB, Ferrucci A,  Volpe M. Therapeutic Approach to Hypertension Urgencies and Emergencies During Acute      Coronary Syndrome. High Blood Press Cardiovasc Prev. 2018 Sep;25(3):253-259. 
11. Paini A, Aggiusti C, Bertacchini F, Agabiti Rosei C, Maruelli G, Arnoldi C, Cappellini S, Muiesan ML, Salvetti M. Definitions and Epidemiological Aspects of Hypertensive Urgencies and Emergencies. High Blood Press Cardiovasc Prev. 2018 Sep;25(3):241-244. 
12. Watson K, Broscious R, Devabhakthuni S, Noel ZR. Focused Update on Pharmacologic Management of Hypertensive Emergencies. Curr Hypertens Rep. 2018 Jun 08;20(7):56. 
13. Viera AJ. Hypertension Update: Hypertensive Emergency and Asymptomatic Severe  Hypertension. FP Essent. 2018 Jun;469:16-19. 
14. Arbe G, Pastor I, Franco J. Diagnostic and therapeutic approach to the hypertensive crisis. Med Clin (Barc). 2018 Apr 23;150(8):317-322. 
15. Salvetti M, Paini A, Bertacchini F, Stassaldi D, Aggiusti C, Agabiti Rosei C, Muiesan ML. Acute blood pressure elevation: Therapeutic approach. Pharmacol Res. 2018 Apr;130:180-190. [
16. Martínez-Díaz AM, Palazón-Bru A, Folgado-de la Rosa DM, Ramírez-Prado D, Navarro-Juan M, Pérez-Ramírez N, Gil-Guillén VF. A one-year risk score to predict all-cause mortality in hypertensive inpatients. Eur J Intern Med. 2019 Jan;59:77-83.

Dr Sourav Chattopadhay

Associate Professor, Dept. of General Medicine, MGM Medical College & LSK Hospital, Kishanganj, Bihar