Hypertensive emergency is common but a severe clinical outcome in hypertensive patients.
The definition of the hypertensive emergency goal blood pressure is not consistent over the literature, but often involves a target organ damage in a situation of emergency.
Treatment practice in hypertensives crisis is difficult because of the lack of evidence supporting the use of one drug over another and a consensuson the posology.
After review of the medical literature, we found only four randomized trials comparing Nitroprussiate to Uradipil or Nifedipine, or nifedipine to captopril. Those trials included only few patients, and Ib or IIb probe level without long term morbidmortality data.
In conclusion, the clinical practice is still far away from the Evidence-based Medicine. Clinical research must go further to prevent cerebral, cardiovascular or renal complications in hypertensive patients.Le texte complet de cet article est disponible en PDF.