…hypertensive emergency is defined by a markedly raised blood pressure in combination with new or progressive acute target organ damage. Common manifestations are hypertensive encephalopathy…

…visual disturbance, chest pain, dyspnoea, dizziness, and neurological deficits. Neurological involvement Hypertensive encephalopathy may present with somnolence, lethargy, tonic–clonic seizures, cortical blindness, and, in…

…increase. Hypertensive crisis Hypertensive urgency: markedly raised pressure without organ involvement — lower it orally over days. Hypertensive emergency: raised pressure with acute organ damage (encephalopathy…

…Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg/h…

…crisis [1,2]. A hypertensive emergency means a markedly raised blood pressure together with ongoing or new organ damage in which immediate, controlled blood pressure…

…signs of acute organ damage or failure. Any of the drugs listed below may be used to treat hypertensive emergencies. The desired time to action…

…signs of acute organ damage or failure. Any of the drugs listed below may be used to treat hypertensive emergencies. The desired time to action…

…obesity. Gestational hypertension is defined in the supplied guideline material as blood pressure 140/90 mmHg on two separate occasions after 20 weeks of gestation…

Enalaprilat Enalaprilat is rarely used in hypertensive crisis due to its slow onset, prolonged duration of effect, and significant individual variations in its effect. Drug…

Hydralazine Hydralazine is not preferred for hypertensive emergencies due to the high risk of reflex sympathetic stimulation. Drug Hydralazine Brand names Apresoline ®, Bidil ®…

…nitroglycerin, nitroprusside, and nicardipine in hypertensive emergencies. Time to onset of action 2 4 minutes Duration of action 5 15 minutes Delivery IV (infusion). Dose…

…Bronchospasm. Caution • Avoided in hypertensive emergencies with left ventricular failure (due to negative inotropic effect). • Used cautiously in patients with asthma (due to risk of…

…Edema. Dizziness. Caution Should be used cautiously in patients with myocardial ischemia and/or heart failure. Nicardipine doses and administration in hypertension (hypertensive crisis/emergency).

Phentolamine Drug Phentolamine Brand names Oraverse ®, Rogitine ® Indications Hypertensive crisis. Mechanism of action Phentolamine is a non selective alpha adrenergic blocker. Phentolamine reduces…

…Increased intra ocular pressure in patients with glaucoma. Caution Used cautiously in patients with glaucoma or increased intracranial pressure. Fenoldopam doses and administration in hypertension.

…administration in these patients should be carefully balanced against the potential risks resulting from hypotension. • Withdrawal of clonidine may lead to rebound hypertension. Withdraw slowly…

…infusion. Adverse effects Flushing. Nausea. Bronchospasm. AV block. Caution • Avoid in acute heart failure. • May cause bradycardia. Esmolol doses and administration in hypertension and tachycardia.

…not be given to pregnant women. • Should not be given to patients with Leber optic atrophy. Nitroprusside doses and administration in hypertension (hypertensive crisis/emergency).

…Flushing. Palpitations. Tolerance with prolonged use. Methemoglobinemia. Hypoxemia. Caution Proceed with caution in afterload dependent conditions. Nitroglycerin doses and administration in hypertension (hypertensive crisis/emergency).

…Lopressor Hct ®, Toprol ®, Seloken ® Indications Mycoardial ischemia. Perioperative hypertension. Mechanism of action Beta 1 adrenergic blocker. Effects Lowers blood pressure, reduces heart…

…conditions, including myocarditis, rapid ventricular rate atrial fibrillation, marked anaemia, hypertensive emergency, heart failure, and end stage renal disease, may produce elevated troponin concentrations. The…

Cardiology Definition and pathophysiology Blood pressure is a continuous cardiovascular exposure rather than a binary distinction between normotension and hypertension. Its long term relationship with…

…but are relatively insensitive findings. Some patients with subacute tamponade may initially remain normotensive or even hypertensive because of compensatory mechanisms. Beck’s Triad The…

…and depression are more common in women. Dyslipidaemia, hypertension, diabetes and obesity become increasingly prevalent after the menopausal transition. Women with type 2 diabetes also…

…respiratory failure, severe anaemia, sustained bradyarrhythmia Increased myocardial oxygen demand Sustained tachyarrhythmia, severe hypertension, hypertensive crisis, critical aortic stenosis, severe hypertrophic cardiomyopathy, extreme exercise Direct…

…potassium, and resistant to suppression by sodium loading. It is the most common form of secondary hypertension. Aldosterone acts principally through the mineralocorticoid receptor (MR)…

…diabetes mellitus, and metabolic syndrome [58] . Hypertension and coronary artery disease (CAD) remain the most potent population attributable risk factors. Furthermore, the "obesity paradox"—whereby…

Cardiology Pharmacology & dosing Definition and Therapeutic Rationale Hypertension is a major risk factor for atherosclerotic cardiovascular disease and contributes to microvascular and macrovascular complications. It…

…However, a growing body of science suggests that essential hypertension is a multifactorial disease caused by a complex interplay between genes and environment. Industrialization and…

Cardiology Respiratory medicine Definition and Pathophysiology Pulmonary hypertension (PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise…

Cardiology Definition and Pathophysiology Resistant hypertension is a clinical indicator rather than a distinct disease. It identifies patients whose blood pressure remains uncontrolled despite intensive…

…apparent treatment resistance. The diagnosis is clinically important because secondary hypertension may be curable when its cause is clearly established and removed. Cure is not…

Calculators CHA2DS2 VASc Score Calculator Congestive Heart Failure Hypertension Age = 75 years Diabetes Mellitus Stroke/TIA/TE Vascular disease Age 65 74 years Sex…

…Definition and Pathophysiology Angiotensin converting enzyme (ACE) inhibitors are foundational therapies in cardiovascular medicine, widely utilized for the management of hypertension, chronic ischemic heart disease…

… 2. Is there cirrhosis, or another strong suspicion of portal hypertension? Variceal and ulcer bleeding are managed differently from the first minute. Peptic ulcer remains…

…effects on the cardiovascular system. Acute exposure produces transient haemodynamic and myocardial effects, whereas sustained heavy consumption is associated with hypertension, coronary artery disease, arrhythmias…

…of cardiovascular disease (CVD), cardiovascular risk factor clustering, disability and premature mortality. Cardiovascular conditions associated with obesity include hypertension, dyslipidaemia, coronary artery disease (CAD), atherosclerosis…

…structurally and functionally altered, and the pathological changes are not explained by coronary heart disease, hypertension, valvular disease or congenital heart disease. Cardiomyopathy leads to…

…to the reduced area of the valvular orifice. Both aortic stenosis and hypertension result in increased ventricular load, which the ventricle counteracts by developing hypertrophy…

…artery into the right ventricle during diastole. The most common cause of abnormal pulmonary regurgitation is pulmonary hypertension. Table 1 presents the causes of pulmonary…

…sweating, anxiety, insomnia, tachycardia, hypertension, headache, nausea and vomiting 8 to 24 hours Alcoholic hallucinosis, often visual, auditory or tactile hallucinations with a relatively clear…

…abnormal 24 hour rhythm should prompt investigation for sleep apnoea, renal disease and secondary hypertension, and lead to one dose being moved to the evening…

… higher in known hypertension Pulse pressure 40–60 mmHg A narrow pulse pressure suggests a low stroke volume Capillary refill < 3 s A simple…

…tau). Measurement of the opening pressure in suspected idiopathic intracranial hypertension. Therapeutic drainage in idiopathic intracranial hypertension and in assessment before shunt surgery. Contraindications Clinical…

…fetal bleeding respectively). Marked liver failure with coagulopathy. Severe uncontrolled hypertension. Recent intracranial haemorrhage without a fresh assessment of benefit and risk. An inability to…

…planning pregnancy, uncontrolled hypertension or annual growth 3 mm. Limitations Formulas assume normal body habitus Ethnic variations may require adjusted thresholds Always correlate with imaging…

…and ORBIT scores. Each incorporates various clinical parameters to stratify bleeding risk. HAS BLED: Incorporates factors such as hypertension, abnormal renal/liver function, stroke history…

…BMI and cardiovascular outcomes High BMI is associated with several health conditions: Type 2 diabetes Hypertension Coronary artery disease Heart failure Dyslipidemia (including high LDL…

…wp most QT prolongation moderate TRIPTODUR TRIPTORELIN triptorelin Heart Damage ar less Hypertension mild VIVITROL NALTREXONE naltrexone Mixed ar less cardiac failure severe Apretude CABOTEGRAVIR…

…of 9. The score takes into account various risk factors that contribute to bleeding risk, including uncontrolled hypertension, impaired renal or liver function, previous stroke…

…As medium dose, and additionally severe hypertension (caution if patient on nonselective beta blockers). Dobutamine Cardiogenic shock Bradycardia (second line therapy) Stress testing (due to…

…of systemic arterial pressure. This renoprotective effect involves a reduction in intraglomerular hyperfiltration and hypertension by disproportionately reducing glomerular efferent arteriolar vasoconstriction. Clinical Presentation and…

…of inflammatory cells. Dyslipidaemia, cigarette smoking, hypertension, diabetes mellitus and other adverse influences disturb these functions. The resulting endothelial dysfunction promotes inappropriate vasoconstriction, adhesion of…

…Consequently, isolated systolic hypertension and widening pulse pressure are common in later life. These changes contribute to the complexity of defining an appropriate treatment target…

…functional capacity Reduce disability and rehospitalization Improve quality of life and self efficacy Address modifiable cardiovascular risk factors Support smoking cessation Improve management of hypertension…

…advanced age, smoking, diabetes, hypertension, cancer, etc – are the most important risk factors for poor outcomes. The vast majority of infections with COVID 19 result…

…acute aortic syndromes, or heart failure have preexisting hypertension. The relationship between blood pressure and outcome in older adults is not linear at very low…

…In contrast, patients with confirmed hypertension generally require BP lowering treatment without additional risk stratification for that treatment decision. Population to which SCORE2 and SCORE2…

…and pericarditis Coronary or large vessel arteritis Pulmonary arterial vasculopathy and pulmonary hypertension Arterial and venous thrombosis Valvular heart disease Cardiac dysrhythmias Arterial stiffness and…

…aetiology is heterogeneous. Chronic heart failure evaluation should therefore seek reversible or treatable causes. The source material identifies coronary disease, hypertension, diabetes, obesity, valvular disease…