Intravenous and oral antihypertensive agents are effective for hypertensive emergencies and urgencies, respectively, though rapid blood pressure normalization poses risks.
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Advocates caution against rapid BP reduction in emergencies; leaves open optimal targets and agents for trials.
Despite advances in chronic hypertension management, hypertensive emergencies and urgencies remain as serious complications. Much of this relates to poor compliance with effective antihypertensive management. Hypertensive emergencies and urgencies can also be seen as the initial manifestations of hypertension in pregnancy and in the perioperative period. Multiple classes of intravenous antihypertensive drugs are available to treat hypertensive emergencies, and specific agents may have an advantage in a given clinical situation. Orally active agents are used to treat hypertensive urgencies, and include clonidine, angiotensin-converting enzyme inhibitors, and labetalol. Most patients respond to drug therapy, but problems may arise related to a rapid normalization of blood pressure.
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Mansoor et al. (2002) studied this question.
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