Special categories of hypertension, Biology

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Hypertensive emergencies are one of the important categories of hypertension and characterized by severe elevations in BP that are complicated by evidence of progressive target organ dysfunction and require immediate BP reduction (not necessarily to normal ranges) to prevent or limit target organ damage. Examples include  hypertensive encephalopathy, intracranial hemorrhage, unstable angina pectoris, or acute myocardial infarction, acute left ventricular failure with pulmonary edema, dissecting aneurysm, or eclampsia. Hypertensive urgencies are severe elevations of BP but without evidence of progressive target organ dysfunction and that may benefit from BP reduction within a few hours.  Examples include upper levels of stage 3 hypertension, papilledema, headache, shortness of breath, or pedal edema. Although hypertensive emergencies will require immediate admission to an intensive care unit (ICU) with continuous BP monitoring and parenteral antihypertensive therapy, most hypertensive urgencies can be managed in the emergency department (ED) with oral agents and appropriate follow-up within 24 hours to several days, depending on the individual characteristics of the patient.


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