Acute Hypertensive Episodes

GENERAL PRINCIPLES

• Acute hypertensive episodes in the hospital are most often caused by inadequately treated essential hypertension. If there is evidence of end organ damage, IV medications are indicated. Oral agents are more appropriate for hypertensive urgency without end organ damage.

• Hypertension associated with withdrawal syndromes (e.g., alcohol, cocaine) and rebound hypertension associated with sudden withdrawal of antihypertensive medications (e.g., clonidine, α-adrenergic antagonists) should be considered.

• Volume overload and pain may exacerbate hypertension and should be recognized appropriately and treated.