Hypertensive crisis: diagnosis, presentation, and treatment Article

Full Text via DOI: 10.1097/HCO.0000000000001049 Web of Science: 001000244900007

Cited authors

  • Stewart MH


  • Purpose of reviewHypertensive crisis (HTN-C) is a condition of increasing prevalence. It carries significant morbidity and mortality, and prompt recognition and treatment are crucial. There is a paucity of controlled trials, so a working knowledge of the most recent literature in the area of HTN-C is helpful.Recent findingsNovel serological markers, including serum corin, have been found to aid in the early identification of end-organ damage from severely elevated blood pressure (BP). In the area of BP following thrombolysis for ischemic stroke, lower target BP (130-140 mmHg) is associated with some improved outcomes. Two large trials of lower BP following mechanical thrombectomy in stroke have failed to show improved outcomes; however, observed data show benefits at lower than currently recommended levels. Clevidipine, a calcium channel blocker marketed for unique use in HTN-C, was found to be noninferior to the generic less expensive nicardipine. Oral nifedipine was found to be the most effective agent for sustained BP reduction in preeclampsia.HTN-C remains an area with few prospective randomized trials, but there is active research on identifying lower goals for specific clinical scenarios. Ideal therapeutic agents should be tailored for specific end-organ damage.

Publication date

  • 2023

Published in

International Standard Serial Number (ISSN)

  • 0268-4705

Number of pages

  • 7

Start page

  • 311

End page

  • 317


  • 38


  • 4