Hypertensive Emergency

Hypertensive Crisis (EM)

HBP + end organ damage (confusion, blurry vision, dyspnea, chest pain, etc.)

Tx

best initial Rx = Labetalol or nitroprusside (needs monitoring with arterial line)

others

Enalapril

CCBs - verapamil, diltiazem

Esmolol

General Management of chronic HTN

Lifestyle advice should not be forgotten and is frequently tested in exams:

• a low salt diet is recommended, aiming for less than 6g/day, ideally 3g/day. The average adult in the UK consumes around 8-12g/day of salt. A recent BMJ paper* showed that lowering salt intake can have a significant effect on blood pressure. For example, reducing salt intake by 6g/day can lower systolic blood pressure by 10mmHg
• caffeine intake should be reduced
• the other general bits of advice remain: stop smoking, drink less alcohol, eat a balanced diet rich in fruit and vegetables, exercise more, lose weight

Management of Hypertension

1. LIfestyle advise