Talk:Hypertensive emergency

Ideal sources for Wikipedia's health content are defined in the guideline Wikipedia:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Hypertensive emergency.

PubMed provides review articles from the past five years (limit to free review articles)
The TRIP database provides clinical publications about evidence-based medicine.
Other potential sources include: Centre for Reviews and Dissemination and CDC

Medicine: Cardiology C‑class Mid‑importance

	Medicine portal This article is within the scope of WikiProject Medicine, which recommends that medicine-related articles follow the Manual of Style for medicine-related articles and that biomedical information in any article use high-quality medical sources. Please visit the project page for details or ask questions at Wikipedia talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine articles
C	This article has been rated as C-class on Wikipedia's content assessment scale.
Mid	This article has been rated as Mid-importance on the project's importance scale.
	This article is supported by the Cardiology task force (assessed as Mid-importance).

incorrect redirection

Malignant hypertension is a rare complication of inhalational anesthetics. It is a completely separate pathology and should not redirect here. — Preceding unsigned comment added by 96.234.191.99 (talk) 02:55, 4 September 2013 (UTC)[reply]

more

more a stage o f hypertension than a complication I think. Unsigned by anon

Yes, but it is a seperate disease entity, as most hypertension patients never get malignant HT. Also, a hypertensive crisis (as in scleroderma) gives symptoms, while a slowly rising BP is generally well tolerated. Please edit the article if you feel the language is unclear. JFW | T@lk 22:35, 26 Sep 2004 (UTC)

Plagirism

This wikipedia article has blatantly plagirized the Emedicine Malignant Hypertension article [1]authored by John D Bisognano, MD.

The following are exact quotes (including order and punctuation) from the Wikipedia article that appear in the eMedicine article:

The Entire HISTORY section

The most common presentations of hypertensive emergencies at an emergency department are chest pain (27%), dyspnea (22%), and neurologic deficit (21%). The primary cardiac symptoms are angina, myocardial infarction, and pulmonary edema. Orthostatic symptoms may be prominent. Neurologic presentations are occipital headache, cerebral infarction or hemorrhage, visual disturbance, or hypertensive encephalopathy (a symptom complex of severe hypertension, headache, vomiting, visual disturbance, mental status changes, seizure, and retinopathy with papilledema). Medications or drugs that may cause a hypertensive emergency include cocaine, monoamine oxidase inhibitors (MAOIs), and oral contraceptives; the withdrawal of beta-blockers, alpha-stimulants (such as clonidine), or alcohol also may cause hypertensive emergency. Renal disease may present as oliguria (renal failure) or any of the typical features of renal failure. Gastrointestinal symptoms are nausea and vomiting.

Most of the PHYSICAL section

Blood pressure must be checked in both arms to screen for aortic dissection or coarctation. If coarctation is suspected, blood pressure also should be measured in the legs. Screen for carotid or renal bruits

Volume status must be assessed, with orthostatic vital signs, examination of jugular veins, assessment of liver size, and investigation for peripheral edema and pulmonary rales.

Renal function should be evaluated through a urinalysis, complete chemistry profile, and complete blood count. Expected findings include elevated BUN and creatinine, hyperphosphatemia, hyperkalemia or hypokalemia, glucose abnormalities, acidosis, hypernatremia, and evidence of microangiopathic hemolytic anemia. Urinalysis may reveal proteinuria, microscopic hematuria, and RBC or hyaline casts. In patients with hyperaldosteronism (a secondary cause of hypertension), aldosterone promotes renal potassium wasting, resulting in low serum potassium. The chest radiograph is useful for assessment of cardiac enlargement, pulmonary edema, or involvement of other thoracic structures, such as rib notching with aortic coarctation or a widened mediastinum with aortic dissection. Other tests, such as head CT scan, transesophageal echocardiogram, and renal angiography, are indicated only as directed by the initial workup. The ECG is necessary to screen for ischemia, infarct, or evidence of electrolyte abnormalities or drug overdose.

I could go on and on. Bodysurf (talk · contribs)

If you are concerned about this please follow the procedure on copyright violations. JFW | T@lk 04:06, 17 March 2006 (UTC)[reply]

Contradicts sodium nitroprusside

The sodium nitroprusside article says it should be given for malignant hypertension, this page says no. RogueNinja_talk 22:39, 27 February 2008 (UTC)[reply]

Copyright?

This article is empty except for the Copyright template. Should it not be removed, then? —Preceding unsigned comment added by 91.66.51.170 (talk) 10:46, 19 March 2008 (UTC)[reply]

No the page was blanked for copyright violations. RogueNinja_talk 18:01, 19 March 2008 (UTC)[reply]

I have reverted to a non copyvio version. Jeepday (talk) 04:49, 30 March 2008 (UTC)[reply]

Table

Hi all, I created this table from the JNC7 guidelines published in JAMA. But for some reason it will only display at the bottom of the page. If someone could help put it under definition I would appreciate it! AStudent (talk) 15:07, 3 June 2011 (UTC)[reply]

Merger proposal

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.

Consensus against merge. -- P 1 9 9 • TALK 12:55, 25 March 2011 (UTC)[reply]

Adrenergic storm is a great article, but it's a duplicate of the article that was already in existence here. That content should be copied and merged with this article. Chaldor (talk) 21:21, 9 August 2008 (UTC)[reply]
I disagree that they should be merged, on the basis that adrenergic storms have a distinct etiology, and can often present with symptoms of hypertension absent or minor -- which is the definition of hypertensive crisis. It's true in most cases the conditions are similiar, but there is enough difference to warrant separate articles. Also, adrenergic storms have a different etiology than hypertensive crises in general, though specific cases may be the same in cause. So, my vote is against merging, obviously. Mr0t1633 (talk) 06:29, 18 October 2008 (UTC)[reply]
- Disagree as well.--Nikbro (talk) 23:31, 15 November 2008 (UTC)[reply]
Adrenergic storm is one aeitology of a hypertensive crisis like the previous person has said. However, we can create an aetiology section in hypertensive crisis underwhich the relevant bits and bobs of adrenergic storm can reside. What do you think of that? —Preceding unsigned comment added by 81.140.74.98 (talk) 21:42, 26 March 2009 (UTC)[reply]
- Disagree with merger, with qualifications. Although these are similar in some ways, treatment of cocaine overdose is different from treatment of typical hypertensive emergencies not related to cocaine. Some of the drugs for hypertensive emergency can actually cause problems with cocaine OD patients. If these ar merged, there should be clear distinction between ordinary hypertensive emergencies and problems related to specific etiologies. While adrenergic storm appears to be a subtype of hypertensive emergency, some of the problems requiring use of sedatives are clearly different in treatment and cause from the usual hypertensive emergency.DBMon (talk) 18:21, 12 June 2009 (UTC)[reply]
Strong Disagree While a Pheochromocytoma (a rare adrenal gland tumor) might cause excess catecholamine release provoking a hypertensive crisis, it should remain a separate article. A mention here would suffice. See also Pheochromocytoma - MayoClinic.com

"Although high blood pressure is a common sign of a pheochromocytoma, most people with high blood pressure don't have a pheochromocytoma." --MornMore (talk) 22:37, 10 January 2010 (UTC)[reply]

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

Should Hypertensive Crisis be 2 categories?

I am not an expert but various sites I read are dividing Hypertensive crisis into 2 categories Hypertensive Urgency (asymptomatic) and Hypertensive Emergency (symptomatic). Geo8rge (talk) 17:07, 15 September 2011 (UTC)[reply]

Malignant Hypertension

Should we consider including malignant hypertension on the chart of hypertension classifications? Ian Glenn (talk) 23:46, 8 October 2011 (UTC)[reply]

2011 Review article

[2] --Doc James (talk · contribs · email) 12:45, 25 November 2011 (UTC)[reply]

Incorrect

No a hypertensive crisis is when the diastolic is over 110. Where is your evidence to prove otherwise? 67.161.207.32 (talk) 08:59, 21 June 2012 (UTC)[reply]

Personal anecdote

My mother went to the hospital on more than one occasion thinking that she had heart attack. Dad would come home and tell us that she didn't have a heart attack but only very high blood pressure, and the doctors were working to bring it down.

When I was around 45 and very healthy, I experienced chest pains. At that time, the cardiologists sent me through a range of tests, including the nuclear treadmill, and concluded they did not know the cause of the chest pains. My personal internist determined that the cause was high blood pressure, in the 150s, and said it was important to bring the BP down to the 120s. He prescribed Metoprolol and Lisinopril, which worked very well for several years in both eliminating the chest pains and keeping the blood pressure low.

Last year, my blood pressure was rising again. Being out of the country, I doubled my dosage of Metoprolol from 25 mg to 50 mg and that brought the BP down but not significantly. When I returned to the U.S. My internist lowered my Metoprolol to 25 mg. Not long afterwards, I had a severe attack of chest pains accompanied by tachycardia, severe dizziness, imbalance, headache, cramps, and slurred speech. I went to the hospital and the doctors said the chest pains were caused by my low heart rate (in the low 40s) and took me off Metoprolol and sent me home. I had explained to them that my low pulse was very normal for me being a runner, and also old (almost 80). I continued to have chest pains, which gradually decreased as we experimented with new drugs, (e.g., Imdur, Amlodipine, Spironolactone, and Losartan.

My BP finally stabilized at 120/60 with a pulse rate of 42 with no chest pains, taking 40 mg of Lisinopril, 10 mg Amlodipine, 25-37.5 HTC-Triamterene, and 30 mg Isosorbide.

It seems to me that "malignant hypertension" is a better expression for the chronic condition of those those, like me and other members of my family, who experience chest pains, tachycardia and the other symptoms whenever their blood pressure goes up. Bdubay (talk) 04:52, 18 April 2015 (UTC)[reply]

Terminology^[1]	Systolic Pressure (mm Hg)	Diastolic Pressure (mm Hg)
Normal	< 120	< 80
Pre-hypertension	120-139	80-89
Hyptertension Stage 1	140-159	90-99
Hyptertension Stage 2	≥ 160	≥ 100
Hypertensive Crisis	≥ 180	≥ 120
Hyptertensive Emergency	≥ 180	≥ 120	With signs of acute organ damage.

^ Chobanian et al. JAMA 2003; 10.

[1] Chobanian et al. JAMA 2003; 10.

[1]