IBCC Episode 29 - Hypertensive Emergency

This podcast addresses the critical care management of hypertensive emergencies, emphasizing the importance of target organ damage over absolute blood pressure numbers. The discussion highlights that a hypertensive emergency is defined by acute kidney injury, type 2 myocardial infarction, hypertensive encephalopathy, or pulmonary edema, rather than a specific blood pressure reading. The speakers advocate for using the MAP (mean arterial pressure) to guide therapy, as it is the most accurate measurement from oscillometric blood pressure monitoring. They review various intravenous antihypertensive agents, categorizing them as titratable, quasi-titratable, or bolus medications, and discuss the transition to oral antihypertensives, cautioning against slow-acting drugs like amlodipine. The podcast concludes with a discussion of Posterior Reversible Encephalopathy Syndrome (PRES), its causes, diagnosis, and management.