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The morbidity and mortality of hypertensive emergencies depend on the extent of end-organ dysfunction at the time of presentation and the degree to which blood pressure is controlled afterward. With good blood pressure control and medication compliance, the 5-year survival rate of patients with hypertensive crises approaches 55%. [1]
For most people, recommendations are to reduce blood pressure to less than or equal to somewhere between 140/90 mmHg and 160/100 mmHg. [2] In general, for people with elevated blood pressure, attempting to achieve lower levels of blood pressure than the recommended 140/90 mmHg will create more harm than benefits, [3] in particular for older people. [4]
Blood pressure varies over longer time periods (months to years) and this variability predicts adverse outcomes. [18] Blood pressure also changes in response to temperature, noise, emotional stress, consumption of food or liquid, dietary factors, physical activity, changes in posture (such as standing-up), drugs, and disease. [19]
Five different medications couldn't control Steven Davis' high blood pressure. Despite taking the pills every day, the 73-year-old Millcreek Township man's blood pressure often remained between ...
A hypertensive urgency is a clinical situation in which blood pressure is very high (e.g., 220/125 mmHg) with minimal or no symptoms, and no signs or symptoms indicating acute organ damage. [1] [2] This contrasts with a hypertensive emergency where severely high blood pressure is accompanied by evidence of progressive organ or system damage. [1]
Lifestyle changes and medications can lower blood pressure and decrease the risk of health complications. [8] Lifestyle changes include weight loss, physical exercise, decreased salt intake, reducing alcohol intake, and a healthy diet. [5] If lifestyle changes are not sufficient, blood pressure medications are used. [8]
Arterial lines are generally not used to administer medication, since many injectable drugs may lead to serious tissue damage and even require amputation of the limb if administered into an artery rather than a vein. [1]
For mild blood pressure elevation, consensus guidelines call for medically supervised lifestyle changes and observation before recommending initiation of drug therapy. However, according to the American Hypertension Association, evidence of sustained damage to the body may be present even prior to observed elevation of blood pressure.
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