Dr. Tom Colletti
Purpose: The purpose of this article is to review hypertensive urgency in the primary care setting and to determine whether to send the patient to the emergency department or treat as an outpatient.
Method: PubMed and Cochrane Database of Systematic Reviews were accessed to perform searches using the terms hypertension, urgency, and primary care. Eleven pertinent articles were retrieved and served as the basis for this clinical review.
Results: There continues to be a lack of evidence-based research to demonstrate whether treating hypertensive urgency in the primary care setting with close follow up is appropriate, instead of referring the patient for rapidly decreasing blood pressure in the emergency department.
Conclusion: Hypertensive urgency is seen in many primary visits. One in seven of all patients hospitalized are experiencing an episode of hypertensive urgency or hypertensive crisis. Untreated hypertensive urgency can lead to hypertensive emergency. The slower lowering of blood pressure over days and not minutes leads to a more favorable outcome and does not increase the workload of an Emergency Department. More research in this area is needed, as there are no published guidelines for a clinician to follow.
Keywords: Hypertension, Urgency, Primary Care, Emergency Department.
Nelson DA. Hypertensive Urgency in Primary Care: Treat or Send to the ED. Lynchburg Journal of Medical Science. 2021; 3(4).
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