Students should be able to:
- Define hypertensive emergency and differentiate from hypertensive
urgency, based on:
- Blood pressure measurement
- Detection of acute target organ injury
- Association of co-morbid conditions
- List the common co-morbid conditions, and recognize the signs and
symptoms, associated with malignant hypertension
- List common drugs or other products associated with elevated blood
- Describe components of a focused exam for the patient with malignant
- Identify abnormal ECG findings associated with the cardiac effects of
malignant HTN, including:
- Left ventricular hypertrophy
- Identify clinical situations where non-hypertensive inpatients may have
elevated blood pressure, and describe appropriate treatments.
- Identify clinical factors relevant to therapeutic management, including:
- Preexisting chronic hypertensive state
- Volume status of the patient
- Concurrent antihypertensive treatment
- Associated co-morbid conditions
- Describe the mechanism and time of action, routes of administration,
starting dose, clinical indications and contraindications, and side effects
of the following drugs in the treatment of malignant hypertension:
- Nitrates: nitroprusside and nitroglycerine
- Beta-blockers including labetalol
- Describe the concept of blood pressure autoregulation and its relevance
to the treatment of malignant hypertension.
- Describe the goals of treatment of the patient with malignant
- Describe a management plan, including bed placement, diagnostic and
therapeutic measures, for:
- The non-hypertensive patient with elevated blood pressure
- The patient with hypertensive urgency
- The patient with malignant hypertension and aortic dissection.
Varon, J. et al. “The Diagnosis and Management of Hypertensive Crises.” Chest, 2000; 118:214-227.
The Seventh Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The JNC7 Report. JAMA 2003;289:2560-2572..