What defines hypertensive urgency?

Hypertensive urgency is characterized specifically by a significant elevation in blood pressure, defined as a systolic blood pressure greater than 180 mmHg or a diastolic blood pressure exceeding 120 mmHg, without the presence of acute end-organ damage. This distinction is crucial, as hypertensive urgency indicates that the blood pressure is dangerously high, requiring intervention, but it does not involve urgent complications such as stroke, myocardial infarction, or acute renal failure, which classify as hypertensive emergency.

This understanding is essential for appropriate management. The treatment of hypertensive urgency typically involves the gradual reduction of blood pressure over 24 to 48 hours, often in an outpatient setting, rather than immediate and aggressive lowering that would be warranted in an emergency situation. Recognizing that the patient does not have acute end-organ damage is a key component of this definition, allowing for a different approach in treatment compared to a hypertensive emergency.

In other scenarios—like significant blood pressure readings with concurrent symptoms or chronic conditions—may indicate a need for treatment, but they do not fit the strict criteria for hypertensive urgency. Therefore, identifying and accurately defining the situation allows clinicians to provide the most appropriate care based on the patient's specific circumstances.