Talk:Hypertensive emergency

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 January 2019 and 1 February 2019. Further details are available on the course page. Student editor(s): Rlenoci. Peer reviewers: Jlee ED.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 00:09, 17 January 2022 (UTC)

incorrect redirection
Malignant hypertension is a rare complication of inhalational anesthetics. It is a completely separate pathology and should not redirect here. — Preceding unsigned comment added by 96.234.191.99 (talk) 02:55, 4 September 2013 (UTC)

more
more a stage o f hypertension than a complication I think. Unsigned by anon


 * Yes, but it is a seperate disease entity, as most hypertension patients never get malignant HT. Also, a hypertensive crisis (as in scleroderma) gives symptoms, while a slowly rising BP is generally well tolerated. Please edit the article if you feel the language is unclear. JFW | T@lk  22:35, 26 Sep 2004 (UTC)

Plagirism
This wikipedia article has blatantly plagirized the Emedicine Malignant Hypertension article authored by John D Bisognano, MD.

The following are exact quotes (including order and punctuation) from the Wikipedia article that appear in the eMedicine article:

The Entire HISTORY section

''The most common presentations of hypertensive emergencies at an emergency department are chest pain (27%), dyspnea (22%), and neurologic deficit (21%). The primary cardiac symptoms are angina, myocardial infarction, and pulmonary edema. Orthostatic symptoms may be prominent. Neurologic presentations are occipital headache, cerebral infarction or hemorrhage, visual disturbance, or hypertensive encephalopathy (a symptom complex of severe hypertension, headache, vomiting, visual disturbance, mental status changes, seizure, and retinopathy with papilledema). Medications or drugs that may cause a hypertensive emergency include cocaine, monoamine oxidase inhibitors (MAOIs), and oral contraceptives; the withdrawal of beta-blockers, alpha-stimulants (such as clonidine), or alcohol also may cause hypertensive emergency. Renal disease may present as oliguria (renal failure) or any of the typical features of renal failure. Gastrointestinal symptoms are nausea and vomiting.''

Most of the PHYSICAL section

''Blood pressure must be checked in both arms to screen for aortic dissection or coarctation. If coarctation is suspected, blood pressure also should be measured in the legs. Screen for carotid or renal bruits''

Volume status must be assessed, with orthostatic vital signs, examination of jugular veins, assessment of liver size, and investigation for peripheral edema and pulmonary rales.

''Renal function should be evaluated through a urinalysis, complete chemistry profile, and complete blood count. Expected findings include elevated BUN and creatinine, hyperphosphatemia, hyperkalemia or hypokalemia, glucose abnormalities, acidosis, hypernatremia, and evidence of microangiopathic hemolytic anemia. Urinalysis may reveal proteinuria, microscopic hematuria, and RBC or hyaline casts. In patients with hyperaldosteronism (a secondary cause of hypertension), aldosterone promotes renal potassium wasting, resulting in low serum potassium. The chest radiograph is useful for assessment of cardiac enlargement, pulmonary edema, or involvement of other thoracic structures, such as rib notching with aortic coarctation or a widened mediastinum with aortic dissection. Other tests, such as head CT scan, transesophageal echocardiogram, and renal angiography, are indicated only as directed by the initial workup. The ECG is necessary to screen for ischemia, infarct, or evidence of electrolyte abnormalities or drug overdose.''

I could go on and on.


 * If you are concerned about this please follow the procedure on copyright violations. JFW | T@lk  04:06, 17 March 2006 (UTC)

Contradicts sodium nitroprusside
The sodium nitroprusside article says it should be given for malignant hypertension, this page says no.  RogueNinja talk  22:39, 27 February 2008 (UTC)

Copyright?
This article is empty except for the Copyright template. Should it not be removed, then? —Preceding unsigned comment added by 91.66.51.170 (talk) 10:46, 19 March 2008 (UTC)


 * No the page was blanked for copyright violations. RogueNinja talk  18:01, 19 March 2008 (UTC)


 * I have reverted to a non copyvio version. Jeepday (talk) 04:49, 30 March 2008 (UTC)

Table
Hi all, I created this table from the JNC7 guidelines published in JAMA. But for some reason it will only display at the bottom of the page. If someone could help put it under definition I would appreciate it! AStudent (talk) 15:07, 3 June 2011 (UTC)

Merger proposal

 * Adrenergic storm is a great article, but it's a duplicate of the article that was already in existence here. That content should be copied and merged with this article. Chaldor (talk) 21:21, 9 August 2008 (UTC)
 * I disagree that they should be merged, on the basis that adrenergic storms have a distinct etiology, and can often present with symptoms of hypertension absent or minor -- which is the definition of hypertensive crisis. It's true in most cases the conditions are similiar, but there is enough difference to warrant separate articles. Also, adrenergic storms have a different etiology than hypertensive crises in general, though specific cases may be the same in cause. So, my vote is against merging, obviously. Mr0t1633 (talk) 06:29, 18 October 2008 (UTC)
 * Disagree as well.--Nikbro (talk) 23:31, 15 November 2008 (UTC)
 * Adrenergic storm is one aeitology of a hypertensive crisis like the previous person has said. However, we can create an aetiology section in hypertensive crisis underwhich the relevant bits and bobs of adrenergic storm can reside. What do you think of that? —Preceding unsigned comment added by 81.140.74.98 (talk) 21:42, 26 March 2009 (UTC)
 * Disagree with merger, with qualifications. Although these are similar in some ways, treatment of cocaine overdose is different from treatment of typical hypertensive emergencies not related to cocaine. Some of the drugs for hypertensive emergency can actually cause problems with cocaine OD patients. If these ar merged, there should be clear distinction between ordinary hypertensive emergencies and problems related to specific etiologies. While adrenergic storm appears to be a subtype of hypertensive emergency, some of the problems requiring use of sedatives are clearly different in treatment and cause from the usual hypertensive emergency.DBMon (talk) 18:21, 12 June 2009 (UTC)
 * Strong Disagree While a Pheochromocytoma (a rare adrenal gland tumor) might cause excess catecholamine release provoking a hypertensive crisis, it should remain a separate article. A mention here would suffice.  See also Pheochromocytoma - MayoClinic.com
 * "Although high blood pressure is a common sign of a pheochromocytoma, most people with high blood pressure don't have a pheochromocytoma." --MornMore (talk) 22:37, 10 January 2010 (UTC)

Should Hypertensive Crisis be 2 categories?
I am not an expert but various sites I read are dividing Hypertensive crisis into 2 categories Hypertensive Urgency (asymptomatic) and Hypertensive Emergency (symptomatic). Geo8rge (talk) 17:07, 15 September 2011 (UTC)

Malignant Hypertension
Should we consider including malignant hypertension on the chart of hypertension classifications? Ian Glenn (talk) 23:46, 8 October 2011 (UTC)

2011 Review article
-- Doc James (talk · contribs · email) 12:45, 25 November 2011 (UTC)

Incorrect
No a hypertensive crisis is when the diastolic is over 110. Where is your evidence to prove otherwise? 67.161.207.32 (talk) 08:59, 21 June 2012 (UTC)

Personal anecdote
My mother went to the hospital on more than one occasion thinking that she had heart attack. Dad would come home and tell us that she didn't have a heart attack but only very high blood pressure, and the doctors were working to bring it down.

When I was around 45 and very healthy, I experienced chest pains. At that time, the cardiologists sent me through a range of tests, including the nuclear treadmill, and concluded they did not know the cause of the chest pains. My personal internist determined that the cause was high blood pressure, in the 150s, and said it was important to bring the BP down to the 120s. He prescribed Metoprolol and Lisinopril, which worked very well for several years in both eliminating the chest pains and keeping the blood pressure low.

Last year, my blood pressure was rising again. Being out of the country, I doubled my dosage of Metoprolol from 25 mg to 50 mg and that brought the BP down but not significantly. When I returned to the U.S. My internist lowered my Metoprolol to 25 mg. Not long afterwards, I had a severe attack of chest pains accompanied by tachycardia, severe dizziness, imbalance, headache, cramps, and slurred speech. I went to the hospital and the doctors said the chest pains were caused by my low heart rate (in the low 40s) and took me off Metoprolol and sent me home. I had explained to them that my low pulse was very normal for me being a runner, and also old (almost 80). I continued to have chest pains, which gradually decreased as we experimented with new drugs, (e.g., Imdur, Amlodipine, Spironolactone, and Losartan).

My BP finally stabilized at 120/60 with a pulse rate of 42 with no chest pains, taking 40 mg of Lisinopril, 10 mg Amlodipine, 25-37.5 HTC-Triamterene, and 30 mg Isosorbide.

It seems to me that "malignant hypertension" is a better expression for the chronic condition of those those, like me and other members of my family, who experience chest pains, tachycardia and the other symptoms whenever their blood pressure goes up. Bdubay (talk) 04:52, 18 April 2015 (UTC)

External links modified
Hello fellow Wikipedians,

I have just added archive links to 1 one external link on Hypertensive emergency. Please take a moment to review my edit. If necessary, add after the link to keep me from modifying it. Alternatively, you can add to keep me off the page altogether. I made the following changes:
 * Added archive http://web.archive.org/web/20110728153143/http://www.vbwg.org/resources/Slide_Lecture.../2/VBWG08_AH2.ppt to http://www.vbwg.org/resources/Slide_Lecture.../2/VBWG08_AH2.ppt

When you have finished reviewing my changes, please set the checked parameter below to true or failed to let others know (documentation at ).

Cheers.—cyberbot II  Talk to my owner :Online 13:44, 29 February 2016 (UTC)

External links modified
Hello fellow Wikipedians,

I have just modified 2 external links on Hypertensive emergency. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:
 * Added archive https://web.archive.org/web/20100203063836/http://wrongdiagnosis.com/h/hypertension/book-diseases-20a.htm to http://www.wrongdiagnosis.com/h/hypertension/book-diseases-20a.htm
 * Added archive https://web.archive.org/web/20110128201355/http://www.severe-hypertension.com/blurredvision.html to http://www.severe-hypertension.com/blurredvision.html

When you have finished reviewing my changes, you may follow the instructions on the template below to fix any issues with the URLs.

Cheers.— InternetArchiveBot  (Report bug) 14:51, 9 November 2017 (UTC)

WikiProject Medicine
Hello,

I will be editing this page to remove outdated material, fix plagiarism concerns, and expanding on the topics listed under hypertensive emergency. Should you have any concerns, please let me know via this talk topic. My main concern is the citations, as many are not meta-analyses or systematic reviews. There are also many outdated resources that will need to be removed.

In terms of specifics, I will expand upon the updated use of the term hypertensive emergency vs malignant hypertension (not to be confused with malignant hyperthermia, as a previous user mentioned). I will discuss hypertensive emergency in the adult and pediatric populations, causes of each, and treatment modalities. I will elaborate the JNC8 classification system of hypertension.

My goal will be to upgrade this paper to a B quality. Thank you.

-rlenoci — Preceding unsigned comment added by Rlenoci (talk • contribs) 14:59, 10 January 2019 (UTC)

WikiProject Medicine Peer Review
Hi Robert,

You did an excellent job with this article and I can see were very thorough with you breakdown of what needed to be done. From what I can see you were able to accomplish all of your major goals for this article and I definitely see the you made it better for all future readers. The use of Tintinalli's emergency medicine book for some of your sources was excellent as that reference text is widely used and held in high esteem in Emergency Medicine communities. While you only had a month to work on this article you were able to accomplish a ton. I've found a couple of suggestions that I will detail in the next line. Some of them could be used for the next editor to work on and some could possibly be done by you if desired.

-In the signs and symptoms section, there are a couple of links that are close to full statements. I thought this felt kind of odd as typically links tend to be one to two words. For example, at one point the article creates a long link for the phrase, "sensation of the world spinning around them" and links it to vertigo. I feel that it might be more intuitive to just put the word vertigo with the link to the Vertigo wiki page. Again, this is something small that might add to the quality of the article.

-In the 2nd paragraph of the pathology section, there are some percentages given but there is no source that comes at the end of the set of facts. There is another source cited earlier in the paragraph but not after the 2 facts that were presented afterwards. Just for clarification where those specific percentages came from it would be nice to either have the same source listed at the end of the paragraph or to track down a systematic review and meta-analysis that could give you some updated numbers or confirm the ones already listed.

-In the See Also section, I think it couldn't hurt to have some type of link to blood pressure control pages and other things for those who may stumble onto the page because they had a medical incident. For example, links to the wiki pages for Blood Pressure, Blood Pressure Management, Pre-Hypertension etc.

The things I listed are rather minor and I think you overall did a great job. — Preceding unsigned comment added by Jlee ED (talk • contribs) 19:19, 30 January 2019 (UTC)

European consensus
10.1093/ehjcvp/pvy032 JFW &#124; T@lk  16:21, 3 February 2021 (UTC)