Therapeutic Approach to Hypertension Urgencies and Emergencies During Acute Coronary Syndrome

Giuliano Tocci, Ilaria Figliuzzi, Vivianne Presta, Francesca Miceli, Barbara Citoni, Roberta Coluccia, Maria Beatrice Musumeci, Andrea Ferrucci, Massimo Volpe

Research output: Contribution to journalReview article

Abstract

Uncontrolled hypertension is one of the most common determinant for the persistently high burden of cardiovascular (CV) disease, mostly including coronary artery disease (CAD) and hospital admissions due to acute coronary events. Markedly high blood pressure (BP) levels are also frequently observed during the acute phase of coronary syndromes (both ST-segment and non-ST-segment elevation myocardial infarction and unstable angina). In particular, a sustained raise of BP levels above 180/110 mmHg associated with acute cardiac organ damage, i.e. myocardial ischemia, represents a condition of hypertension emergency and requires rapid hospital admission, prompt pharmacological therapies and non-pharmacological interventions, aimed at restoring coronary flow and preserve vital myocardium. Diagnosis of CAD in hypertensive patients may often be complicated by the concomitant presence of electrocardiographic abnormalities, such as ST-segment depression (at rest or during exercise), which may occur even in the absence of coronary atherosclerosis. Thus, proper identification of CAD may result difficult to perform in the setting of clinical practice, mostly in the presence of left ventricular hypertrophy. In this review, we will briefly discuss diagnostic protocols and pharmacological strategies that can be applied in a setting of hypertension emergency with acute cardiac organ damage in the light of the currently available evidence and recommendations from recent guidelines on hypertension management and control.

Original languageEnglish
Pages (from-to)253-259
Number of pages7
JournalHigh Blood Pressure and Cardiovascular Prevention
Volume25
Issue number3
DOIs
Publication statusPublished - Sep 1 2018

Keywords

  • Acute coronary syndrome
  • Blood pressure
  • Essential hypertension
  • Hypertension emergency
  • Hypertension urgency
  • Myocardial infarction
  • Unstable angina

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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