Hypertensive Crisis

A severe, acute increase in BLOOD PRESSURE that may result in STROKE or MYOCARDIAL ISCHEMIA.

Also Known As:

Crises, Hypertensive; Crisis, Hypertensive; Emergencies, Hypertensive; Emergency, Hypertensive; Hypertensive Crises; Hypertensive Emergencies; Hypertensive Urgencies; Urgencies, Hypertensive; Urgency, Hypertensive; Hypertensive Emergency; Hypertensive Urgency

Networked: 1727 relevant articles (134 outcomes, 110 trials/studies)

Relationship Network

Disease Context: Research Results

Cardiovascular Diseases: 91362
- Vascular Diseases: 15138
  - Hypertension: 147135
    - Hypertensive Crisis: 1727

Related Diseases

1.	Hypertension (High Blood Pressure)
2.	Hypertensive Crisis
3.	Pre-Eclampsia (Preeclampsia)
4.	Pheochromocytoma
5.	Hemorrhage

Experts

1.	Varon, Joseph: 6 articles (07/2014 - 06/2007)
2.	Conzo, Giovanni: 5 articles (01/2014 - 01/2013)
3.	Pasquali, Daniela: 5 articles (01/2014 - 01/2013)
4.	Santini, Luigi: 5 articles (01/2014 - 01/2013)
5.	Golikov, A P: 5 articles (01/2004 - 01/2000)
6.	Napolitano, Salvatore: 4 articles (01/2014 - 01/2013)
7.	Carpéné, Christian: 3 articles (05/2022 - 09/2016)
8.	Beyl, Robbie A: 3 articles (11/2021 - 01/2021)
9.	Gillard, Christopher J: 3 articles (11/2021 - 01/2021)
10.	Guillory, Shane G: 3 articles (11/2021 - 01/2021)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Hypertensive Crisis:

1.	Nifedipine (Adalat)FDA LinkGeneric 01/01/1982 - "It is concluded that nifedipine given by the oral route is an effective agent for the rapid lowering of elevated blood pressure and deserves further evaluation as an agent for the management of hypertensive emergencies." 11/01/1985 - "Nifedipine appears to be a safe, effective agent for the management of hypertensive emergencies. " 11/01/1987 - "Nifedipine appears to be safe and effective in the management of hypertensive crises." 11/01/1985 - "We propose nifedipine as a simple, effective and safe alternative drug for managing hypertensive emergencies in childhood." 01/01/1983 - "Nifedipine is a simple, effective, and safe alternative drug for managing hypertensive emergencies, especially when continuous monitoring of the patient cannot be guaranteed."
2.	Labetalol (Normodyne)FDA LinkGeneric 05/01/1989 - "Labetalol is very effective in hypertensive pregnant women and in hypertensive crises, where it provides good control of blood pressure without serious adverse effects, and where few therapeutic options exist. " 10/17/1983 - "Labetalol is a safe and effective treatment for a rapid blood pressure reduction in hypertensive emergencies." 04/01/1991 - "Labetalol provides safe and effective treatment for hypertensive urgencies when administered orally in doses of 100 to 300 mg." 01/01/2011 - "Safety and efficacy of intravenous labetalol for hypertensive crisis in infants and small children." 07/01/2022 - "This was a prospective randomized non-blinded study which included 50 patients of hypertensive crises, out which 25 patients received intravenous labetalol and 25 patients received intravenous nitroglycerine. "
3.	Antihypertensive Agents (Antihypertensives)IBA 11/01/2009 - "For hypertensive urgencies, it is not known which class of antihypertensive drug provides the best results and there is controversy regarding when to use antihypertensive drugs and which ones to use in these situations. " 01/01/1990 - "Our results showed: 1) a satisfactory control of the hypertensive crises in 80% of patients treated with SLC with a significant blood pressure reduction after 10 min. (13/8 mmHg, p less than 0.02), while the maximum hypotensive effect was achieved after 30 min. (52/36 mmHg, p less than 0.001); SLN was able to reduce blood pressure in 90% of all the cases, with a significant reduction after 5 min. (15/11 mmHg, p less than 0.02) and hypotensive peak after 20 min (57/38 mmHg, p greater than 0.001); 2) no significant differences for hypotensive effectiveness between the two groups, but with SLC having a mildly delayed onset of action when compared to SLN; 3) antihypertensive effect lasting for about 6 hours in patients treated with SLC and blood pressure progressively raising after 4 hours in patients who received SLN; 4) a significant correlation between blood pressure reduction and blood pressure before drug administration in both groups; a significant correlation between pretreatment PRA and antihypertensive effect in the SLC group. " 09/01/2008 - "This treatment strategy, based on standardized rest as an initial step and different antihypertensive drugs, can be effective and safe for the management of patients with hypertensive urgencies." 02/01/1977 - "The clinical pharmacology and appropriate choice of antihypertensive agents useful in the treatment of hypertensive emergencies are reviewed. " 01/01/2023 - "The objective of this study was to determine whether time to initiation of oral antihypertensives impacts blood pressure (BP) reduction in patients with hypertensive urgency. "
4.	Captopril (Capoten)FDA LinkGeneric 09/01/1992 - "Sublingual captopril is highly effective in hypertensive crisis and its gradual hypotensive action avoid dangerous abrupt fall in blood pressure." 09/01/1994 - "Because the efficacy of C, its rapid onset of action and minimal side effects, sublingual Captopril should be considered a first line drug for hypertensive crises." 03/01/2021 - "The study concluded that the dose of 25 mg of captopril is effective in managing hypertensive urgency and controlling the blood pressure. " 02/01/1989 - "The aim of this study, whose preliminary findings are reported, is to evaluate the efficacy of captopril, administered by a sublingual route, in the treatment of hypertensive emergencies. " 03/01/2021 - "This study aimed to evaluate the clinical outcomes of captopril use for hypertensive urgency at a selection of Sudanese emergency centres. "
5.	Clonidine (ST 155)FDA LinkGeneric 12/01/1984 - "Changes in cardiac function after effective treatment of hypertensive emergencies with i.v. clonidine." 01/01/1986 - "It is concluded that clonidine is an effective and safe alternative in the treatment of hypertensive emergencies." 12/01/1984 - "It is concluded that clonidine is an effective and safe alternative in the treatment of hypertensive emergencies." 04/01/2022 - "Safety And Efficacy of Clonidine for Acute Hypertensive Urgency in an Older and Hospitalized Population." 04/01/1979 - "During the recovery period in 2 out of 10 patients in whom clonidine medication was discontinued, a hypertensive crisis occurred, which was relieved by clonidine readministration. "
6.	Nitroprusside (Sodium Nitroprusside)FDA LinkGeneric 11/01/1982 - "Sodium nitroprusside is effective in most cases of hypertensive crisis and must be administered intravenously under continuous observation." 01/01/2022 - "According to the articles reviewed in this work, beta-blockers seem to be safe and effective in hypertensive crises, more than sodium nitroprusside, although limited data are available. " 06/01/1991 - "Sodium nitroprusside is effective in reducing arterial blood pressure in hypertensive crisis as a result of systemic vasodilation leading to a reduction in preload and afterload. " 03/28/2018 - "As sodium nitroprusside is very rarely used for hypertensive crisis in neonates, we would like to share our experiences on dosage, challenges in administration due to its fast onset of action, criteria for monitoring for complications and finally weaning. " 01/01/2009 - "Sodium nitroprusside is an extremely toxic drug, and its use in the treatment of hypertensive emergencies should be avoided. "
7.	Nicardipine (Dagan)FDA LinkGeneric 05/01/2000 - "Nicardipine is a safe and effective agent in pediatric hypertensive emergencies." 04/01/2011 - "In adults, the treatment of hypertensive emergencies with intravenous nicardipine is well-documented, but for an evaluation of safety in pediatric use, the published studies and case reports appear to be barely adequate. " 01/01/2024 - "Nicardipine is commonly used in the management of hypertensive crises, except those involving cardiac contractility defects despite its ability to reduce afterload and pulmonary congestion. " 01/01/2024 - "Utility of nicardipine in the management of hypertensive crises in adults with reduced ejection fractions." 01/01/2022 - "However, nicardipine is frequently used to treat hypertensive emergencies, including AHFS. "
8.	urapidilIBA 01/01/2018 - "We studied patients with hypertensive emergencies before and 4 h after BP lowering by urapidil (n = 12) and studied the release of EMPs due to mechanical endothelial injury after coronary angiography (n = 10). " 10/01/2015 - "Urapidil is more efficient in hypertensive urgency treatment, since the decrease of middle artery pressure (MAP) in the group treated with urapidil was statistically significant (p<0,001). " 01/01/2014 - "The review considers the possibility of using parenteral urapidil for treatment of hypertensive crises. " 01/01/2013 - "[Place of urapidil in the treatment of hypertensive crises from the standpoint of clinical pharmacology and evidence-based medicine]." 01/01/2012 - "[Hypertensive crisis in cardiology: place of urapidil]."
9.	Hydralazine (Apresoline)FDA LinkGeneric 07/01/1982 - "Until further studies are conducted, hydralazine will continue to be the treatment of choice for hypertensive emergencies of pregnancy." 09/01/2002 - "The data suggest that hydralazine bolus dose is equally safe and more effective than continuous drip in the management of hypertensive emergencies in pregnancy." 09/01/2002 - "Management of hypertensive emergencies of pregnancy by hydralazine bolus injection vs continuous drip--a comparative study." 02/01/2001 - "A hypertensive crisis developed during surgery but was resolved within minutes after administration of hydralazine. " 05/01/1991 - "[Use of intravenous hydralazine in treatment of hypertensive crisis]."
10.	Fenoldopam (Corlopam)FDA LinkGeneric 07/01/2005 - "This review discusses the treatment of hypertensive emergencies in general and the therapeutic role of fenoldopam in particular." 06/01/2000 - "Fenoldopam safely and effectively lowers blood pressure in a dose-dependent manner in patients with hypertensive emergencies. " 07/01/1999 - "It was concluded that fenoldopam offers significant advantages as a parenterally administered agent for the management of blood pressure in both hypertensive emergencies and in the perioperative setting." 10/01/1997 - "Fenoldopam: a review of its pharmacodynamic and pharmacokinetic properties and intravenous clinical potential in the management of hypertensive urgencies and emergencies." 10/01/1996 - "Fenoldopam is a selective peripheral DA1 agonist now being developed as a parenteral treatment for hypertensive emergencies. "

Therapies and Procedures

1.	Therapeutics 06/01/2000 - "The efficacy of sustained therapy was determined by comparing the number of patients in each group who experienced a pulmonary hypertensive crisis. " 08/01/1988 - "Despite the lack of comparative trials with traditional agents, demonstrated efficacy and desirable pharmacologic characteristics have made several new agents acceptable for therapy of hypertensive crises." 01/01/2022 - "Currently there are scarce epidemiological data regarding prevalence, clinical phenotype, and therapy of hypertensive urgencies (HU) and emergencies (HE). " 01/01/2019 - "Although both shunts had bidirectional flow, based on the results of acute pulmonary vasoreactive testing, one-stage surgical closure was performed followed by up-front combination therapy for post-operative pulmonary hypertensive crisis and residual PAH. " 01/01/2018 - "As a result, multi-organ dysfunctions in the heart, brain, liver, kidney, vascular endothelium, and blood system were testified in the modeling rats at weeks 6 and 8. In conclusion, severe consequences of this animal model were highly similar to those in hypertensive crises emergencies, which could be further utilized in the early intervention of hypertensive crises emergencies including the possible risk factors control and efficient therapies assessment. "
2.	Coronary Artery Bypass (Coronary Artery Bypass Surgery) 08/01/1987 - "Hypertensive crisis during coronary artery bypass graft surgery: a case of unsuspected pheochromocytoma." 04/01/1995 - "Initial studies have shown that intravenous isradipine is effective in controlling hypertension following coronary artery bypass graft surgery and that it appears useful in the treatment of intraoperative hypertension and hypertensive crisis, and in hypertensive disorders in pregnancy, when administered orally or intravenously. " 05/01/2002 - "Intravenous fenoldopam may be useful in the treatment of hypertension associated with coronary artery bypass surgery or in hypertensive emergencies. " 10/01/1997 - "Fenoldopam may be particularly useful in patients who develop hypertension after coronary artery bypass graft surgery, but further studies are required to confirm its role in hypertensive emergency." 01/01/1989 - "[Comparative study of nifedipine and nicardipine in the treatment of hypertensive crisis after aortocoronary bypass]."
3.	Drug Therapy (Chemotherapy) 01/01/1990 - "The above method of non-drug therapy proves highly effective in the treatment of hypertensive crises of different types, produced no side effects and can be used in a hospital as a cost-effective procedure." 03/01/1991 - "These results indicate that N, C, and a variety of drug therapies are equally effective and safe in the treatment of hypertensive urgencies." 10/01/2021 - "Drug therapy for hypertensive emergency is influenced by end-organ involvement, pharmacokinetics, potential adverse drug effects, and patient comorbidities. " 10/01/2021 - "True hypertensive emergencies are characterized by a rapid elevation in blood pressure to a level above 180/120 mmHg and are associated with acute target organ damage, which requires immediate hospitalization for close hemodynamic monitoring and IV pharmacotherapy. " 09/01/2017 - "Drug therapy should be started in elderly hypertensive patients if lifestyle changes are insufficient and in the absence of a hypertensive emergency or urgency, blood pressure reduction should always be gradual. "
4.	Adrenalectomy 04/01/2021 - "Objective: We examined the incidence of perioperative hypertensive crisis in robot-assisted retroperitoneal laparoscopic adrenalectomy. " 01/01/2009 - "Underdiagnosis resulted in dangerous adrenal biopsy or adrenalectomy with hypertensive crisis and nearly doubled the length of stay in hospital. " 04/01/2023 - "Once the patient was stable and deemed fit for surgery, a robotic adrenalectomy followed by ventriculoperitoneal shunt placement began. After induction of anesthesia, the patient went into hypertensive emergency again. " 01/01/2015 - "Postpartum transabdominal laparoscopic adrenalectomy for pheochromocytoma presenting with abruption and hypertensive emergency." 07/01/2013 - "Hypertensive crisis during adrenalectomy in a patient with pheochromocytoma and a HOCM with SAM."
5.	Aftercare (After-Treatment) 04/15/2008 - "Two cases were complicated postoperatively with II degree atrial ventricular block and one with pulmonary hypertensive crisis, and all were cured after treatment. " 07/15/2013 - "The acute impact of hypertensive crisis, and changes after treatment, on left ventricular (LV) systolic and diastolic function using comprehensive echocardiography, including speckle tracking, has not been well characterized. " 09/01/2000 - "Moreover, autonomic dysreflexia associated with bladder emptying that manifested as a hypertensive crisis during voiding disappeared after treatment in the 3 patients with tetraplegia. " 02/01/2008 - "After treatment with phenoxybenzamine, bilateral adrenalectomy was performed and resulted in remission of Cushing's syndrome and hypertensive crisis. "