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An update on hypertensive emergencies and urgencies

Muiesan, Maria Lorenza; Salvetti, Massimo; Amadoro, Valentina; di Somma, Salvatore; Perlini, Stefano; Semplicini, Andrea; Borghi, Claudio; Volpe, Massimo; Saba, Pier Sergio; Cameli, Matteo; Ciccone, Marco Matteo; Maiello, Maria; Modesti, Pietro Amedeo; Novo, Salvatore; Palmiero, Pasquale; Scicchitano, Pietro; Rosei, Enrico Agabiti; Pedrinelli, Robertothe Working Group on Hypertension, Prevention, Rehabilitation of the Italian Society of Cardiology, the Societa’ Italiana dell’Ipertensione Arteriosa (SIIA)

Journal of Cardiovascular Medicine: May 2015 - Volume 16 - Issue 5 - p 372–382
doi: 10.2459/JCM.0000000000000223

Severe acute arterial hypertension is usually defined as ‘hypertensive crisis’, although ‘hypertensive emergencies’ or ‘hypertensive urgencies’, as suggested by the Joint National Committee and the European Society of Hypertension, have completely different diagnostic and therapeutic approaches.

The prevalence and demographics of hypertensive emergencies and urgencies have changed over the last four decades, but hypertensive emergencies and urgencies are still associated with significant morbidity and mortality.

Different scientific societies have repeatedly produced up-to-date guidelines; however, the treatment of hypertensive emergencies and urgencies is still inappropriate, with potential clinical implications.

This review focuses on hypertensive emergencies and urgencies management and treatment, as suggested by recent data.

aDepartment of Clinical and Experimental Sciences University of Brescia, 25100 Spedali Civili, Brescia

bDepartment of Medical-Surgery Sciences and Translational Medicine, Emergency Department, University La Sapienza, Sant’Andrea Hospital Rome, Rome

cDepartment of Internal Medicine and Therapeutics, University of Pavia, Lombardy

dDepartment of Internal Medicine 1, USL12 Veneziana, Venice

eDepartment of Medicine, University of Padua, Padova

fDepartment of ScienzeMediche e Chirurgiche, S.Orsola-Malpighi University Hospital, Bologna

gDivision of Cardiology, Department of Medicina Clinica e Molecolare, University Roma ‘Sapienza’ – Azienda Ospedaliera Sant’Andrea, and IRCCS Neuromed, Rome

hDivision of Cardiology, AOU Sassari, Sassari

iDepartment of Cardiovascular Diseases, University of Siena, Tuscany

jCardiovascular Disease Section, Department of Emergency and Organ Tranplantation, University of Bari, Bari

kAS Department of Cardiology, Brindisi District, Brindisi

lDepartment of Clinical and Experimental Medicine, University of Florence, Florence

mDepartment of Internal Medicine and Cardiovascular Diseases, University of Palermo, Palermo

nDipartimento di Patologia Chirurgica, Medica, Molecolare e dell’Area Critica, Università di Pisa, Pisa, Italy

Correspondence to Maria Lorenza Muiesan, MD, Department of Clinical and Experimental Sciences University of Brescia, Spedali Civili, Brescia, 25100 Italy E-mail:

Received 23 May, 2014

Revised 3 September, 2014

Accepted 5 September, 2014

© 2015 Italian Federation of Cardiology. All rights reserved.