Acute Hypertensive Episodes

Acute Hypertensive Episodes is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • Acute hypertensive episodes in the hospital are most often caused by inadequately treated essential hypertension. If there is evidence of end-organ damage, IV medications are indicated. Oral agents are more appropriate for hypertensive urgency without end-organ damage.
  • Hypertension associated with withdrawal syndromes (e.g., alcohol, cocaine) and rebound hypertension associated with sudden withdrawal of antihypertensive medications (i.e., clonidine, α-adrenergic antagonists) should be considered. These entities should be treated as discussed in Chapter 3, Preventive Cardiology.
  • Volume overload and pain may exacerbate hypertension and should be recognized appropriately and treated.

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General Principles

  • Acute hypertensive episodes in the hospital are most often caused by inadequately treated essential hypertension. If there is evidence of end-organ damage, IV medications are indicated. Oral agents are more appropriate for hypertensive urgency without end-organ damage.
  • Hypertension associated with withdrawal syndromes (e.g., alcohol, cocaine) and rebound hypertension associated with sudden withdrawal of antihypertensive medications (i.e., clonidine, α-adrenergic antagonists) should be considered. These entities should be treated as discussed in Chapter 3, Preventive Cardiology.
  • Volume overload and pain may exacerbate hypertension and should be recognized appropriately and treated.

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