BP ≥180/120 with (emergency) or without (urgency) acute end-organ damage.
Investigations
- • 12-lead ECG, troponin
- • U&E, urinalysis (haematuria, proteinuria)
- • Fundoscopy
- • CT brain if neuro symptoms
Management
- • Urgency: oral agents, gradual reduction over 24-48 h
- • Emergency: IV agents (labetalol, nicardipine, GTN, nitroprusside)
- • Target: reduce MAP 10-20% first hour, then further 5-15% next 23 h
- • Exceptions: aortic dissection SBP <120 rapidly; ischaemic stroke lytic <185/110; ICH <140
Complications
- • Hypertensive encephalopathy
- • Aortic dissection
- • Papilloedema, retinal haemorrhage
Related in WardRound
Educational — verify locally.
