Algorithm for managing hypertensive crises


DOI: https://dx.doi.org/10.18565/therapy.2020.8.113-122

Almazova I.I., Aliyeva A.M., Rakhaev A.M., Komissarova M.S., Reznik E.V., Nikitin I.G.

1) National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia, Moscow; 2) N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow; 3) Main Bureau of Medical and Social Expertise in the Kabardino-Balkarian Republic of the Ministry of Labor of Russia, Nalchik
Arterial hypertension (AH) is one of the main risk factors for cardiovascular morbidity and mortality. The prevalence of hypertension among the adult population of the planet is 30–45%, in Russia – 40–47%. In 2025, the number is expected to grow from AH to 1,5 billion people.
Hypertensive crises are a frequent complication of hypertension and become the reason for seeking emergency, outpatient and inpatient medical care. In recent years, the leading expert cardiological communities have revised the concept of «hypertensive crisis» and, as a consequence, the tactics of patient management. This article provides an overview of modern ideas about the optimal therapeutic tactics for diagnosing and treating patients with hypertensive crisis.
Keywords: hypertensive crisis, antihypertensive drugs, arterial hypertension
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Literature


  1. Кобалава Ж.Д., Конради А.О., Недогода С.В. с соавт. Артериальная гипертензия у взрослых. Клинические рекомендации – 2020. Российский кардиологический журнал. 2020; 3: 149–218. [Kobalava Zh.D., Konradi A.O., Nedogoda S.V. et al. Arterial hypertension in adults. Clinical guidelines 2020. Rossiyskiy kardiologicheskiy zhurnal. 2020; 3: 149–218 (In Russ.)]. doi: 10.15829/1560-4071-2020-3-3786.

  2. Алгоритмы ведения пациента с артериальной гипертензией и гипертоническим кризом. Разработчик: Общероссийская общественная организация «Содействия профилактике и лечению артериальной гипертензии “Антигипертензивная лига”». Санкт-Петербург. 2019. Издание первое. [Algorithms for managing a patient with arterial hypertension and hypertensive crisis. Developer: All-Russian public organization «Promotion of prevention and treatment of arterial hypertension “Antihypertensive League”». Saint-Petersburg. 2019. First edition (In Russ.)].

  3. Гиляревский С.Р. Изменение представлений о тактике при остром выраженном повышении артериального давления в отсутствие поражения органов-мишеней. Южно-российский журнал терапевтической практики. 2020; 1: 33–37. [Gilyarevsky S.R. Changing perceptions of tactics in acute marked increase in blood pressure in the absence of damage to target organs. Yuzhno-Rossiyskiy zhurnal terapevticheskoy praktiki. 2020; 1: 33–37 (In Russ.)]. doi: https://doi.org/10.21886/2712-8156-2020-1-1-33-37.

  4. Чазова И.Е., Жернакова Ю.В. от имени экспертов. Клинические рекомендации. Диагностика и лечение артериальной гипертонии. Системные гипертензии. 2019; 1: 6–31. [Chazova I.E., Zhernakova Yu.V. on behalf of the experts. Clinical guidelines. Diagnosis and treatment of arterial hypertension. Systemnye gipertenzii. 2019; 1: 6–31 (In Russ.). doi: 10.26442/2075082X.2019.1.190179.

  5. 2018 ЕОК/ЕОАГ рекомендации по лечению больных с артериальной гипертензией. Российский кардиологический журнал. 2018; 12:143–228. [2018 ESC/ESH Guidelines for the management of arterial hypertension. Rossiyskiy kardiologicheskiy zhurnal. 2018; 12: 143–228 (In Russ.)]. doi: http://dx.doi.org/10.15829/1560-4071-2018-12-143-228.

  6. Ahmed N., Wahlgren N., Brainin M. et al. SITS Investigators. Relationship of blood pressure, antihypertensive therapy, and outcome in ischemic stroke treated with intravenous thrombolysis: retrospective analysis from Safe Implementation of Thrombolysis in Stroke-International Stroke Thrombolysis Register (SITS-ISTR). Stroke. 2009; 40(7): 2442–49. doi: 10.1161/STROKEAHA.109.548602.

  7. van den Born B.-J.H., Lip G.Y.H., Brguljan-Hitij J. et al. ESC Council on hypertension position document on the management of hypertensive emergencies. Eur Heart J Cardiovasc Pharmacother. 2019; 5(1): 37–46. doi: 10.1093/ehjcvp/pvy032.

  8. Lee M., Ovbiagele B., Hong K.S. et al. Effect of blood pressure lowering in early ischemic stroke: meta-analysis. Stroke. 2015; 46(7): 1883–89. doi: 10.1161/STROKEAHA.115.009552.

  9. Patel K.K., Young L., Howell E.H. et al. Characteristics and outcomes of patients presenting with hypertensive urgency in the office setting. JAMA Intern Med. 2016; 176(7): 981–88. doi: 10.1001/jamainternmed.2016.1509.

  10. Qureshi A.I., Palesch Y.Y., Barsan W.G. et al. Intensive blood-pressure lowering in patients with acute cerebral hemorrhage. N Engl J Med. 2016; 375(11): 1033–43. doi: 10.1056/NEJMoa1603460.

  11. Rimoldi S.F., Scherrer U., Messerli F.H. Secondary arterial hypertension: when, who, and how to screen? Eur Heart J. 2014; 35(19): 1245–54. doi: 10.1093/eurheartj/eht534.

  12. Zhao R., Liu F.D., Wang S. et al. Blood pressure reduction in the acute phase of an ischemic stroke does not improve short- or long-term dependency or mortality: a meta-analysis of current literature. Medicine (Baltimore). 2015; 94(23): e896. doi:10.1097/MD.0000000000000896.


About the Autors

Ilda I. Almazova, PhD, doctor-teacher of the methodological accreditation and simulation center of National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Healthcare of Russia. Address: 101000, Moscow, 10 Petroverigsky Lane. Tel.: +7 (916) 903-94-83. E-mail: almazovai@rambler.ru
Amina M. Alieva, PhD, associate professor of the Department of hospital therapy No. 2 of medical faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia. Address: 117437, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (906) 733-08-31. E-mail: amisha_alieva@mail.ru
Alik M. Rakhaev, MD, head of expert staff of Main Bureau of Medical and Social Expertise in the Kabardino-Balkarian Republic of the Ministry of Labor of Russia. Address: 360003, Nalchik, 131B Tarchokova Str. E-mail: alikrahaev@yandex.ru
Maria S. Komissarova, assistant of the Department of hospital therapy No. 2 of medical faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, researcher, Research Laboratory of Rheumatic Diseases of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, functional diagnostics doctor of City clinical hospital named after V.M. Buyanov of Moscow Healthcare Department. Address: 115516, Moscow, 26/10 Bakinskaya Str. Tel.: +7 (906) 770-70-80; +7 (495) 321-55-44. E-mail: komissarova.m.s@gmail.com
Elena V. Reznik, MD, professor of the Department of hospital therapy No. 2 of medical faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Senior researcher of Research Laboratory of Rheumatic Diseases of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, cardiologist, therapist, functional diagnostics doctor of City clinical hospital named after V.M. Buyanov of Moscow Healthcare Department. Address: 115516, Moscow, 26/10 Bakinskaya Str. Tel.: +7 (916) 380-39-23; +7 (495) 321-55-44. E-mail: elenaresnik@gmail.com. ORCID: 0000-0001-7479-418X. ResearcherID N-6856-2016
Igor G. Nikitin, MD, professor, head of the Department of hospital therapy No. 2 of medical faculty of N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, director of Treatment and Rehabilitation Center of the Ministry of Healthcare of Russia. Address: 117437, Moscow, 1 Ostrovityaninova Str. Tel.: +7 (916) 616-57-27; +7 (495) 321-55-44. E-mail: igor.nikitin.64@mail.ru. ORCID: 0000-0003-1699-0881


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