Está en la página 1de 13

HYPERTENSI CRISIS

Dr. LEONARDO DAIRY, SpPD KGEH

HYPERTENSI CRISIS
Merupakan keadaan yg ditandai
tekanan darah yang sangat tinggi
dengan kemungkinan akan timbulnya
atau telah terjadinya kelainan organ

Hypertensive

Urgencies

Emergencies and

Clinically,thesesituationscanbeclassifiedeitheras

EMERGENCYHYPERTENSION (HIPERTENSI
DARURAT)
URGENCYHPERTENSION
(HIPERTENSIMENDESAK)

TARGET ORGAN DAMAGE

HYPERTENSIVE EMERGENCY
Thetermhypertensiveemergencyisdefinedas

severehypertensionorasuddenincreaseinblood
pressurewithevidenceofacuteinjurytotarget
organs(eg,brain,heart,kidney,vasculature,and
retina.
Examplesincludemalignanthypertension,
hypertensiveencephalopathy,aorticdissection,
unstableangina,acutemyocardialinfarction,
eclampsia,pulmonaryedema,andacuterenal
failure.

Hypertensiveencephalopathy:papilledema,

headache,somnolence,confusion,stupor,
gastrointestinaltractdistress,visualloss,focal
neurologicdeficits,coma,andseizures
.Hypertensiiveemergencyrequiresubstantial
reductionofbloodpressurewithin1hourtoavoid
theriskofmorbidityordeath.
Itimpliestheneedforhospitalizationto
immediatelylowerbloodpressurewithparenteral
therapy.

The

initial goal in hypertensive


emergencies is to reduce the pressure
by no more than 25% MABP ( minutes
to 1 or 2 hours) and then toward a
level of 160/100 mmHg within 2-6
hours.

HYPERTENSIVE URGENCY
Thetermhypertensiveurgencyisdefinedassevere

hypertensionwithoutevidenceofacutetargetorgan
injurybutoccurringinasettinginwhichitis
importanttodecreasebloodpressuretosaferlevels
overa24to48hourperiod.
Treatmentisadministeredorallyandhospitalization
usuallyisnotrequired.

PHARMACOLOGIC TREATMENT
(PARENTERAL AGENTS)

Nitroprusside sodium
Nitroglycerin,intravenous
Labetalol
Esmolol
Nicardipine
Fenoldopam
Enalaprilat
Diazoxide
Hydralazinde
Trimethapan
Diuretics

PHARMACOLOGIC TREATMENT
(ORAL AGENTS)

Clonidine
Captopril
Nifedifine

As

soon as possible, initiate regular oral


treatment and taper intravenous treatment.
After blood pressure has been controlled,
search for the cause of the hypertensive crisis
and consider secondary causes, especially
renovascular disease, pheochromocytoma, and
primary aldosteronism.

First-line antihypertensive
drugs
Diuretic
s
blockers

ACE
inhibitors

1
blockers

Ca
antagonists
Angiotensin II
antagonists

Combination Therapies

-adrenergic blockers and diuretics


ACE inhibitors and diuretics
Angiotensin II receptor antagonists and
diuretics
Calcium antagonists and ACE inhibitors
Other combinations

THANK YOU

También podría gustarte