Hypertensive crisis, defined as an increase in systolic blood pressure >179 mmHg or diastolic blood pressure >109 mmHg, typically causes end-organ damage; the brain is an elective and early target, among others. The strong relationship between arterial hypertension and cerebrovascular diseases is supported by extensive evidence, with hypertension being the main modifiable risk factor for both ischemic and hemorrhagic stroke, especially when it is uncontrolled or rapidly increasing. However, despite the large amount of data on the preventive strategies and therapeutic measures that can be adopted, the management of high BP in patients with acute cerebrovascular diseases presenting at the emergency department is still an area of debate. Overall, the outcome of stroke patients with high blood pressure values basically depends on the occurrence of hypertensive emergency or hypertensive urgency, the treatment regimen adopted, the drug dosages and their timing, and certain stroke features. In this narrative review, we provide a timely update on the current treatment, debated issues, and future directions related to hypertensive crisis in patients referred to the emergency department because of an acute cerebrovascular event. This will also focus greater attention on the management of certain stroke-related, time-dependent interventions, such as intravenous thrombolysis and mechanic thrombectomy.

中文翻译：

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急诊科就诊的急性脑血管疾病高血压危象：叙述回顾


高血压危象定义为收缩压升高>179 mmHg或舒张压升高>109 mmHg，通常会导致终末器官损伤；其中，大脑是一个选择性的早期目标。动脉高血压与脑血管疾病之间的密切关系得到了广泛证据的支持，高血压是缺血性和出血性中风的主要可改变危险因素，特别是当高血压不受控制或迅速增加时。然而，尽管有大量关于可采取的预防策略和治疗措施的数据，但急诊科就诊的急性脑血管疾病患者的高血压管理仍然是一个争论领域。总体而言，高血压值脑卒中患者的结局基本上取决于高血压急症或高血压急症的发生、采用的治疗方案、药物剂量和用药时机以及某些脑卒中特征。在这篇叙述性综述中，我们及时更新了因急性脑血管事件转诊至急诊科的患者的高血压危象的当前治疗、有争议的问题和未来方向。这也将更加关注某些与中风相关的、时间依赖性干预措施的管理，例如静脉溶栓和机械血栓切除术。