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Article:Hypertension
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Severely elevated blood pressure (equal to or greater than a systolic 180 or diastolic of 110 — sometime termed malignant or accelerated hypertension) is referred to as a "hypertensive crisis", as blood pressures above these levels are known to confer a high risk of complications. People with blood pressures in this range may have no symptoms, but are more likely to report headaches (22% of cases)<ref>{{cite journal |author=Papadopoulos DP, Mourouzis I, Thomopoulos C, Makris T, Papademetriou V |title=Hypertension crisis |journal=Blood Press. |volume=19 |issue=6 |pages=328–36 |year=2010 |month=December |pmid=20504242 |doi=10.3109/08037051.2010.488052 |url=}}</ref> and dizziness than the general population.<ref name=Fisher2005/> Other symptoms accompanying a hypertensive crisis may include visual deterioration or breathlessness due to heart failure or a general feeling of [[malaise]] due to renal failure.<ref name="ABC" /> Most people with a hypertensive crisis are known to have elevated blood pressure, but additional triggers may have led to a sudden rise.<ref name=Marik2007>{{cite journal |author=Marik PE, Varon J |title=Hypertensive crises: challenges and management |journal=Chest |volume=131 |issue=6 |pages=1949–62 |year=2007 |month=June |pmid=17565029 |doi=10.1378/chest.06-2490 |url=http://chestjournal.chestpubs.org/content/131/6/1949.long}}</ref>
 
Severely elevated blood pressure (equal to or greater than a systolic 180 or diastolic of 110 — sometime termed malignant or accelerated hypertension) is referred to as a "hypertensive crisis", as blood pressures above these levels are known to confer a high risk of complications. People with blood pressures in this range may have no symptoms, but are more likely to report headaches (22% of cases)<ref>{{cite journal |author=Papadopoulos DP, Mourouzis I, Thomopoulos C, Makris T, Papademetriou V |title=Hypertension crisis |journal=Blood Press. |volume=19 |issue=6 |pages=328–36 |year=2010 |month=December |pmid=20504242 |doi=10.3109/08037051.2010.488052 |url=}}</ref> and dizziness than the general population.<ref name=Fisher2005/> Other symptoms accompanying a hypertensive crisis may include visual deterioration or breathlessness due to heart failure or a general feeling of [[malaise]] due to renal failure.<ref name="ABC" /> Most people with a hypertensive crisis are known to have elevated blood pressure, but additional triggers may have led to a sudden rise.<ref name=Marik2007>{{cite journal |author=Marik PE, Varon J |title=Hypertensive crises: challenges and management |journal=Chest |volume=131 |issue=6 |pages=1949–62 |year=2007 |month=June |pmid=17565029 |doi=10.1378/chest.06-2490 |url=http://chestjournal.chestpubs.org/content/131/6/1949.long}}</ref>
   
A "hypertensive emergency", previously "malignant hypertension", is diagnosed when there is evidence of direct damage to one or more organs as a result of the severely elevated blood pressure. This may include [[hypertensive encephalopathy]], caused by brain swelling and dysfunction, and characterized by headaches and an [[altered level of consciousness]] (confusion or drowsiness). Retinal [[papilloedema]] and/or fundal [[hemorrhages]] and [[exudates]] are another sign of target organ damage. [[Chest pain]] may indicate [[acute coronary syndrome|heart muscle damage]] (which may progress to [[myocardial infarction]]) or sometimes [[aortic dissection]], the tearing of the inner wall of the [[aorta]]. [[Dyspnea|Breathlessness]], cough, and the expectoration of blood-stained sputum are characteristic signs of [[pulmonary edema]], the swelling of lung tissue due to [[left ventricular failure]] an inability of the [[left ventricle]] of the heart to adequately pump blood from the lungs into the arterial system.<ref name=Marik2007/> [[Acute kidney injury|Rapid deterioration of kidney function]] (acute kidney injury) and [[microangiopathic hemolytic anemia]] (destruction of blood cells) may also occur.<ref name=Marik2007/> In these situations, rapid reduction of the blood pressure is mandated to stop ongoing organ damage.<ref name=Marik2007/> In contrast there is no evidence that blood pressure needs to be lowered rapidly in hypertensive urgencies where there is no evidence of target organ damage and over aggressive reduction of blood pressure is not without risks.<ref name="ABC" /> Use of oral medications to lower the BP gradually over 24 to 48 h is advocated in hypertensive urgencies.<ref name=Marik2007/>
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A "hypertensive emergency", previously "malignant hypertension", is diagnosed when there is evidence of direct damage to one or more organs as a result of the severely elevated blood pressure. This may include [[hypertensive encephalopathy]], caused by brain swelling and dysfunction, and characterized by headaches and an [[altered level of consciousness]] (confusion or drowsiness). Retinal [[papilloedema]] and/or fundal [[hemorrhages]] and [[exudates]] are another sign of target organ damage. [[Chest pain]] may indicate [[acute coronary syndrome|heart muscle damage]] (which may progress to [[myocardial infarction]]) or sometimes [[aortic dissection]], the tearing of the inner wall of the [[aorta]]. [[Dyspnea|Breathlessness]], cough, and the expbitches be lik wait hold upectoration of blood-stained sputum are characteristic signs of [[pulmonary edema]], the swelling of lung tissue due to [[left ventricular failure]] an inability of the [[left ventricle]] of the heart to adequately pump blood from the lungs into the arterial system.<ref name=Marik2007/> [[Acute kidney injury|Rapid deterioration of kidney function]] (acute kidney injury) and [[microangiopathic hemolytic anemia]] (destruction of blood cells) may also occur.<ref name=Marik2007/> In these situations, rapid reduction of the blood pressure is mandated to stop ongoing organ damage.<ref name=Marik2007/> In contrast there is no evidence that blood pressure needs to be lowered rapidly in hypertensive urgencies where there is no evidence of target organ damage and over aggressive reduction ofi aint doing this shit blood pressure is not without risks.<ref name="ABC" /> Use of oral medications to lower the BP gradually over 24 to 48 h is advocated in hypertensive urgencies.<ref name=Marik2007/>
   
 
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