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Hypertensive Crisis (HC)

 гипертонический криз











First aid

It is recommended mainly oral medications, which provide a gradual reduction in blood pressure within 24-48 hours in the treatment of uncomplicated HC. Treatment of uncomplicated HC on an outpatient basis, emergency hospitalization is not required. In some cases, patients with uncomplicated HC hospitalize.

Indications for hospitalization of these patients may be the following factors:

• uncertainty about the diagnosis, the need for specialized (often invasive) investigations to clarify the case of the Arterial Hypertension;

• difficulty in selecting drug therapy at a pre-hospital stage (frequent HC, resistant to treatment AH). After correction of the HC is carried out routine treatment of hypertension. The choice of tactics therapeutic interventions (drug, route of administration, expected rate, the size of BP reduction) depends on the severity of HC and the presence of complications. Decisive importance in the treatment of HC has both the absolute level of achievement of blood pressure, and the correct interpretation of complaints and symptoms of the patient. In the treatment of HC to pay attention to the pathological mechanisms underlying hypertension.

At treatment ГК it is necessary to pay attention to the pathological mechanisms underlying a hypertensia. So, at a neurovegetative crisis, considering lying in its basis excitation of a CNS, the vegetative centers and an emission hypertonia, treatment is expedient for beginning with using of sedative preparations in a combination to beta-blockers.

In the water-salt Stroke in the foreground use of diuretics in combination with the peripheral vasodilator, sympatholytic. In these cases, however, have a good effect korinfar and (or) clonidine. Effective were droperidol, chlorpromazine, administered according to the level of blood pressure by intramuscular or intravenosis. With the threat of stroke or Acute Left Ventricle Failure, Myocardial Infarction it is necessary to use high-speed preparations. These include pentamin, administered by slow intravenous bolus, or, better yet, an IV driply. Last way of introduction gives the chance to control BP level. To a controlled hypotension is advisable to use a arfonad or chlorpromazine, sodium nitroprusid driply. A good hypotensive effect has labetalol, influencing simultaneously on an alpha- and beta receptors and their blockade.

The reason of absence of effect at hypotensive therapy can be:

  • hypervolemia (insufficient dose diuretics and (or) surplus using of salt);
  • • excessive receiving diuretics, which reduces the Volume of blood circulation and activity of a renin and catecholamines;
  • salt depletion in patients with interstitial renal disease.




Used literature




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