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2020, Number 1

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Arch Med Fam 2020; 22 (1)

Hypertensive crisis: an integral approach from primary care

Palmero-Picazo J, Rodríguez-Gallegos MF, Martínez-Gutiérrez R

Language: Spanish
References: 30
Page: 27-38
PDF size: 383.41 Kb.


ABSTRACT

The hypertensive crisis consists of a systolic elevation› 180 mmHg and diastolic elevation› 120 mmHg. It is subdivided into hypertensive urgency when it shows no alteration to white organ. Or as a hypertensive emergency, when blood pressure can cause repercussions in white organ. The latter is associated with greater morbidity and mortality in patients. Hypertension affects 25% of the adult population. In this, 13.95% of the budget allocated to health is invested. The hypertensive crisis occurs before any stressful phenomenon which influences some physiological mechanism of blood pressure control. The most common forms of hypertensive emergency are hypertensive encephalopathy, stroke, acute coronary syndrome, acute lung edema, aortic dissecting aneurysm and eclampsia. The diagnosis is made through a medical history focused on heredofamily antecedents, pathological personnel, interrogation of devices and systems, physical examination, laboratory and cabinet studies that confirm the diagnostic suspicion. The treatment in the hypertensive emergency aims to lower 20% of the pressure in 24-72 hours, with Captopril being the medication of first choice by mouth. While in the hypertensive emergency it is sought to reduce 25% in 1-2 hours intravenously, with urosemide, nitroglycerin and labetalol being the most used drugs.


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