Diagnosis of hypertensive emergencies not based on numbers
Sir,
While there is a great deal to be said for simplifying treatment
thresh olds in hypertension, using a diastolic measurement of 125 mm Hg to
diagnose malignant HTN seems strange.
The diagnosis of hypertensive emergency rests on the demonstration of
ongoing end-organ damage in the face of elevated blood pressure. The
actual value is less important.
Many patients presenting with diastolic BPs in excess of 125 mm Hg do not
have ongoing end organ damage and are better classified as having
hypertensive urgency.
Whereas a 30% decrease in BP over 30-60 minutes is usually
recommended for hypertensive emergency,hypertensive urgency warrants
control over 24-48 hours.
Rapid Response:
Diagnosis of hypertensive emergencies not based on numbers
Sir,
While there is a great deal to be said for simplifying treatment
thresh olds in hypertension, using a diastolic measurement of 125 mm Hg to
diagnose malignant HTN seems strange.
The diagnosis of hypertensive emergency rests on the demonstration of
ongoing end-organ damage in the face of elevated blood pressure. The
actual value is less important.
Many patients presenting with diastolic BPs in excess of 125 mm Hg do not
have ongoing end organ damage and are better classified as having
hypertensive urgency.
Whereas a 30% decrease in BP over 30-60 minutes is usually
recommended for hypertensive emergency,hypertensive urgency warrants
control over 24-48 hours.
yours sincerely,
Competing interests: No competing interests