Characteristics and Outcomes of Patients Presenting With Hypertensive Urgency in the Office Setting

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Abstract
Quiz Ref ID Approximately one-third of the US population has hypertension, which is associated with an increased risk for end-organ damage, mainly myocardial infarction, heart failure, stroke, and kidney damage.1-4 For chronic uncontrolled hypertension, every 20–mm Hg increase in systolic blood pressure (SBP) or 10–mm Hg increase in diastolic blood pressure (DPB) is associated with doubling of vascular mortality.5 Because organ damage results from increased blood pressure over time, physicians may be concerned about the potential for end-organ damage after severely elevated blood pressure, even for short periods. Hypertensive urgency is defined as SBP of at least 180 mm Hg and/or DBP of at least 110 mm Hg, without associated end-organ damage.6-8 The prevalence of hypertensive urgency in the outpatient setting is unknown, and management is complicated by a lack of observational studies or randomized clinical trials. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommended gradual blood pressure control for 24 to 48 hours,4 but this was not addressed in the eighth report.9

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