Treatment-hypertensive crises

(Circ 2018;138:e426)

• AoD, eclampsia/severe preeclampsia, pheo: target SBP <140 (<120 for AoD) in 1 hour
• Emerg w/o above: ↓ BP by ~25% in 1 h; to 160/100–110 over next 2–6 h, then nl over 1–2 d
• Acute ischemic stroke (w/in 72 hr from sx onset): <185/110 before lysis initiated, o/w target <220/120 (same SBP goal for ICH)
• Watch UOP, Cr, mental status: may indicate a lower BP is not tolerated IV Drugs for Hypertensive Crises
• HTN urgency: goal to return to normal BP over hrs to days. Reinstitute/intensify anti-HTN Rx. Additional PO options: labetalol 200–800 mg q8h, captopril 12.5–100 mg q8h, hydralazine 10–75 mg q6h, clonidine 0.2 mg load → 0.1 mg q1h.