HYPERTENSIVE CRISIS IN URGENT AND EMERGENT SETTINGS
SCIENTIFIC EVIDENCE
DOI:
https://doi.org/10.54620/cadesp.v20secaotematica.2832Keywords:
Hypertensive Crisis, Hypertension, Hospital Emergency ServiceAbstract
Introduction: Hypertensive crises are a frequent occurrence in urgent and emergency care settings, requiring careful clinical assessment to distinguish between situations involving acute target-organ damage and those without it. Objective: This integrative review aims to analyze recent scientific evidence regarding the management of hypertensive crises in adults within urgent and emergency care settings, focusing on clinical management, prognosis, and post-discharge follow-up strategies. Methods: The study selection process followed PRISMA 2020 guidelines. A total of 1,950 records were identified across the PubMed, LILACS, Scopus, and Cochrane databases. After removing duplicates and screening titles and abstracts, 19 articles were evaluated in full, resulting in the inclusion of 7 studies. Data extraction covered authors, year, country, study type, objectives, interventions, outcomes, and key findings; analysis was conducted using a thematic approach. Results: Findings showed that significant blood pressure elevations in the emergency department are associated with an increased cardiovascular risk, particularly in the weeks following the encounter. However, in patients without acute target-organ damage, aggressive blood pressure reduction did not demonstrate consistent benefits regarding mortality, stroke, or major cardiovascular events. Evidence supports prioritizing risk stratification, gradual blood pressure reduction, therapeutic adjustment, patient education, and early outpatient follow-up. Conclusion: Safe management of hypertensive crises depends on distinguishing between hypertensive emergencies and significant blood pressure elevations without target-organ damage, as well as on the integration between emergency care and primary care services.
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