Page 64 - Clinical Pearls in Cardiology

52 Clinical Pearls in Cardiology

then decreases gradually throughout the day, reaching its
lowest point at night (in the early morning hours between
2 am and 5 am). In healthy normotensive people, the
mean intra-arterial pressure falls by approximately 20%
during the period from waking up in the morning to
retiring to bed at night.
35. What is meant by hypertensive urgency?
Hypertensive urgencies are situations where the high
blood pressure has to be reduced within hours. These
include the following:
1. Persons with asymptomatic severe hypertension
(systolic blood pressure more than 220 mm Hg or
diastolic blood pressure more than 120 mm Hg).
2. Those with evidence of nonprogressive target organ
damage (target organs include the heart, the kidneys,
the eyes and the brain).
3. Perioperative hypertension (intravenous fenoldopam
is the preferred parenteral agent for managing
perioperative hypertension).
36. What is meant by hypertensive emergency?
Hypertensive emergencies are situations with rapidly
progressing target organ damage, where the high blood
pressure has to be reduced within minutes.

Hypertensive emergencies
• Hypertensive encephalopathy
• Intracranial hemorrhage
• Aortic dissection
• Preeclampsia and eclampsia
• Acute pulmonary edema
• Acute myocardial infarction