Introduction: Hypertensive Urgency and Emergency Management

Hypertensive emergencies are acute, severe elevations in blood pressure that result in end-organ damage. They represent a small subset of hypertensive crises but require prompt medical attention to prevent morbidity and mortality. The incidence of hypertensive emergencies is increasing, with an estimated 2 emergency department visits per 1000 adults diagnosed each year. As frontline healthcare providers, pharmacists play a critical role in the assessment and management of these high-risk patients. Key aspects in caring for patients with hypertensive emergencies include prompt identification of end-organ involvement, use of parenteral antihypertensive therapy, close monitoring, and transitions of care. Recent advancements include novel parenteral agents and growing evidence surrounding optimal blood pressure targets and timeframes, but controversies remain regarding rapidity of reduction. This subtopic will provide an overview of the pathophysiology, clinical presentation, diagnosis, and management of hypertensive emergencies to inform clinical pharmacists aiming for board certification.