Hypertensive Crisis in Acute Cerebrovascular Diseases Presenting at the Emergency Department: A Narrative Review
Hypertensive crisis, defined as an increase in systolic blood pressure >179 mmHg or diastolic blood pressure >109 mmHg, typically causes end-organ damage; the brain is an elective and early target, among others. The strong relationship between arterial hypertension and cerebrovascular diseases...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-01-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/11/1/70 |
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| author | Mariagiovanna Cantone Giuseppe Lanza Valentina Puglisi Luisa Vinciguerra Jaime Mandelli Francesco Fisicaro Manuela Pennisi Rita Bella Rosella Ciurleo Alessia Bramanti |
| author_facet | Mariagiovanna Cantone Giuseppe Lanza Valentina Puglisi Luisa Vinciguerra Jaime Mandelli Francesco Fisicaro Manuela Pennisi Rita Bella Rosella Ciurleo Alessia Bramanti |
| author_sort | Mariagiovanna Cantone |
| collection | DOAJ |
| description | Hypertensive crisis, defined as an increase in systolic blood pressure >179 mmHg or diastolic blood pressure >109 mmHg, typically causes end-organ damage; the brain is an elective and early target, among others. The strong relationship between arterial hypertension and cerebrovascular diseases is supported by extensive evidence, with hypertension being the main modifiable risk factor for both ischemic and hemorrhagic stroke, especially when it is uncontrolled or rapidly increasing. However, despite the large amount of data on the preventive strategies and therapeutic measures that can be adopted, the management of high BP in patients with acute cerebrovascular diseases presenting at the emergency department is still an area of debate. Overall, the outcome of stroke patients with high blood pressure values basically depends on the occurrence of hypertensive emergency or hypertensive urgency, the treatment regimen adopted, the drug dosages and their timing, and certain stroke features. In this narrative review, we provide a timely update on the current treatment, debated issues, and future directions related to hypertensive crisis in patients referred to the emergency department because of an acute cerebrovascular event. This will also focus greater attention on the management of certain stroke-related, time-dependent interventions, such as intravenous thrombolysis and mechanic thrombectomy. |
| first_indexed | 2024-03-09T05:50:03Z |
| format | Article |
| id | doaj.art-48e6b0c78f2e48b48a18e5fedcdfa17f |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-09T05:50:03Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-48e6b0c78f2e48b48a18e5fedcdfa17f2023-12-03T12:18:01ZengMDPI AGBrain Sciences2076-34252021-01-011117010.3390/brainsci11010070Hypertensive Crisis in Acute Cerebrovascular Diseases Presenting at the Emergency Department: A Narrative ReviewMariagiovanna Cantone0Giuseppe Lanza1Valentina Puglisi2Luisa Vinciguerra3Jaime Mandelli4Francesco Fisicaro5Manuela Pennisi6Rita Bella7Rosella Ciurleo8Alessia Bramanti9Department of Neurology, Sant’Elia Hospital, ASP Caltanissetta, Via Luigi Russo, 6, 93100 Caltanissetta, ItalyDepartment of Surgery and Medical-Surgical Specialties, University of Catania, Via Santa Sofia, 78, 95123 Catania, ItalyDepartment of Neurology and Stroke Unit, ASST Cremona, Viale Concordia, 1, 26100 Cremona, ItalyDepartment of Neurology and Stroke Unit, ASST Cremona, Viale Concordia, 1, 26100 Cremona, ItalyDepartment of Neurosurgery, Sant’Elia Hospital, ASP Caltanissetta, Via Luigi Russo, 6, 93100 Caltanissetta, ItalyDepartment of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia, 89, 95123 Catania, ItalyDepartment of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia, 89, 95123 Catania, ItalyDepartment of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Via Santa Sofia, 78, 95123 Catania, ItalyIRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113, Via Palermo C/da Casazza, 98123 Messina, ItalyIRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113, Via Palermo C/da Casazza, 98123 Messina, ItalyHypertensive crisis, defined as an increase in systolic blood pressure >179 mmHg or diastolic blood pressure >109 mmHg, typically causes end-organ damage; the brain is an elective and early target, among others. The strong relationship between arterial hypertension and cerebrovascular diseases is supported by extensive evidence, with hypertension being the main modifiable risk factor for both ischemic and hemorrhagic stroke, especially when it is uncontrolled or rapidly increasing. However, despite the large amount of data on the preventive strategies and therapeutic measures that can be adopted, the management of high BP in patients with acute cerebrovascular diseases presenting at the emergency department is still an area of debate. Overall, the outcome of stroke patients with high blood pressure values basically depends on the occurrence of hypertensive emergency or hypertensive urgency, the treatment regimen adopted, the drug dosages and their timing, and certain stroke features. In this narrative review, we provide a timely update on the current treatment, debated issues, and future directions related to hypertensive crisis in patients referred to the emergency department because of an acute cerebrovascular event. This will also focus greater attention on the management of certain stroke-related, time-dependent interventions, such as intravenous thrombolysis and mechanic thrombectomy.https://www.mdpi.com/2076-3425/11/1/70ischemic strokehemorrhagic strokecerebrovascular eventsarterial hypertensionhypertensive crisismanagement |
| spellingShingle | Mariagiovanna Cantone Giuseppe Lanza Valentina Puglisi Luisa Vinciguerra Jaime Mandelli Francesco Fisicaro Manuela Pennisi Rita Bella Rosella Ciurleo Alessia Bramanti Hypertensive Crisis in Acute Cerebrovascular Diseases Presenting at the Emergency Department: A Narrative Review Brain Sciences ischemic stroke hemorrhagic stroke cerebrovascular events arterial hypertension hypertensive crisis management |
| title | Hypertensive Crisis in Acute Cerebrovascular Diseases Presenting at the Emergency Department: A Narrative Review |
| title_full | Hypertensive Crisis in Acute Cerebrovascular Diseases Presenting at the Emergency Department: A Narrative Review |
| title_fullStr | Hypertensive Crisis in Acute Cerebrovascular Diseases Presenting at the Emergency Department: A Narrative Review |
| title_full_unstemmed | Hypertensive Crisis in Acute Cerebrovascular Diseases Presenting at the Emergency Department: A Narrative Review |
| title_short | Hypertensive Crisis in Acute Cerebrovascular Diseases Presenting at the Emergency Department: A Narrative Review |
| title_sort | hypertensive crisis in acute cerebrovascular diseases presenting at the emergency department a narrative review |
| topic | ischemic stroke hemorrhagic stroke cerebrovascular events arterial hypertension hypertensive crisis management |
| url | https://www.mdpi.com/2076-3425/11/1/70 |
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