Hypertensive Urgency: Very high BP without acute end-organ damage or only retinal changes, therefore BP can be lowered in hours to days, preferably slowly, sometimes in an outpatient setting
Hypertensive Crisis Criteria
Level of blood pressure and/or rapidity of increase
Life-threatening involvement of CNS or cardiovascular system and/or a clinical setting deemed dangerous
The Clinical Syndromes of Severe Hypertension
HYPERTENSIVE CRISES
_Malignant hypertension
_Hypertensive encephalopathy
_Benign hypertension with acute dysfunction of neurologic or cardiovascular system
_Catecholamine excess states
_Preoperative and postoperative hypertension
_Preeclampsia and eclampsia
_Scleroderma renal crisis, acute glomerulonephritis
Malignant or Accelerated Hypertension: Essential Diagnostic Features
Elevation of blood pressure, usually severe and fixed, occurring over days to weeks
Grade III or IV hypertensive retinopathy
Renal abnormalities: proteinuria, microscopic hematuria, renal dysfunction
Progressive decline of kidney function
Etiologies of Malignant Hypertension
Primary or essential malignant hypertension
Secondary malignant hypertension
Acute glomerulonephritis
Renovascular hypertension
Chronic kidney diseases
All causes of hypertension can evolve to malignant hypertension with the exception of coarctation of the aorta
Malignant hypertension has been reported with primary aldosteronism, Cushing’s syndrome and pheochromocytoma but very infrequently
Primary or essential hypertension is the most common etiology overall, particularly among persons of African descent.
Primary or essential hypertension as a cause of malignant hypertension is less common among caucasians and children

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