🩺 Hypertensive Emergency Management
This tool separates hypertensive emergency from urgency and, by target organ, gives the BP goal, rate of reduction, and preferred IV agent.
Hypertensive Emergency Management
Acute target-organ damage
Involved target organ (when emergency)
When to use
Use to triage acute target-organ damage to controlled IV therapy with organ-specific targets, and to manage urgency with gradual oral lowering.
How it works
No acute organ damage → urgency, oral, gradual over 24–48 h. Emergency → IV; general rule first-hour SBP reduction ≤ 25%; organ-specific targets (dissection 110–120/HR < 60, eclampsia < 160/110, etc.) and preferred drugs.
Key points
- Hypertensive urgency is harmed by rapid lowering, so sublingual short-acting nifedipine is avoided and oral agents are used over hours. (original synthesis · not guideline verbatim)
- Aortic dissection and eclampsia need rapid, specific targets rather than the general 25%/hour rule.
- Nitroprusside is contraindicated in eclampsia because of fetal cyanide toxicity.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.