Emergency Medicine Board Bombs 252. High blood pressure: will your head explode?
Mar 2, 2025
Explore the humorous yet informative case of a man with high blood pressure in the emergency department. The hosts discuss when high blood pressure treatment is urgent versus emergent. They emphasize evidence-based practices and clarify myths surrounding hypertensive emergencies. Discover effective medications for critical conditions, such as esmolol and labetalol, while examining the risks of aggressive treatment for asymptomatic patients. This engaging dialogue is both enlightening and entertaining, perfect for anyone in emergency medicine!
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Managing Asymptomatic Hypertension
- Don't aggressively lower blood pressure in asymptomatic patients.
- Have them relax in a quiet room for 30 minutes to an hour and reassess.
Hypertensive Urgency Is Not an Emergency
- Asymptomatic hypertension is not an emergency, but patients should follow up with a primary care doctor.
- Discharging these patients without aggressive treatment is the evidence-based approach.
Defining Hypertensive Emergency
- Hypertensive emergency isn't just high blood pressure; it's high blood pressure plus end-organ damage.
- The treatment varies based on the specific end-organ damage present.