The management of hypertensive crises

Hypertensive crises are associated with a high mortality, particularly when prompt and effective therapy is delayed. The majority of these patients should be managed with rapid-acting orally-active antihypertensive drugs. In the presence of hypertensive encephalopathy, left ventricular failure, myocardial infarction or aortic dissection, parenteral therapy may be required. The over-rapid reduction of blood pressure may itself be dangerous and parenteral treatment should only be administered in high dependency or intensive care units.