Editing Hypertension (section)

===Hypertensive crisis===
{{main|Hypertensive crisis}}
Severely elevated blood pressure (equal to or greater than a systolic of 180 mmHg or diastolic of 120 mmHg) is referred to as a hypertensive crisis.<ref>{{Cite web | work = Center for Drug Evaluation and Research|date=2021-01-21 |title=High Blood Pressure – Understanding the Silent Killer |url=https://www.fda.gov/drugs/special-features/high-blood-pressure-understanding-silent-killer |publisher = U.S. Food and Drug Administration |language=en}}</ref> Hypertensive crisis is categorized as either [[hypertensive urgency]] or [[hypertensive emergency]], according to the absence or presence of end-organ damage, respectively.<ref>{{cite journal | vauthors = Rodriguez MA, Kumar SK, De Caro M | title = Hypertensive crisis | journal = Cardiology in Review | volume = 18 | issue = 2 | pages = 102–107 | date = 2010-04-01 | pmid = 20160537 | doi = 10.1097/CRD.0b013e3181c307b7 | s2cid = 34137590 }}</ref><ref>{{Cite web|title = Hypertensive Crisis|url = http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Hypertensive-Crisis_UCM_301782_Article.jsp|website = heart.org|access-date = 2015-07-25|url-status = live|archive-url = https://web.archive.org/web/20150725220209/http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Hypertensive-Crisis_UCM_301782_Article.jsp|archive-date = 25 July 2015}}</ref>

In hypertensive urgency, there is no evidence of end-organ damage resulting from the elevated blood pressure. In these cases, oral medications are used to lower the BP gradually over 24 to 48 hours.<ref name="Marik2007">{{cite journal | vauthors = Marik PE, Varon J | title = Hypertensive crises: challenges and management | journal = Chest | volume = 131 | issue = 6 | pages = 1949–1962 | date = June 2007 | pmid = 17565029 | doi = 10.1378/chest.06-2490 | url = http://chestjournal.chestpubs.org/content/131/6/1949.long | url-status = dead | archive-url = https://archive.today/20121204174126/http://chestjournal.chestpubs.org/content/131/6/1949.long | archive-date = 2012-12-04 }}</ref>

In a hypertensive emergency, there is evidence of direct damage to one or more organs.<ref name=JNC7/><ref name="Perez">{{cite journal | vauthors = Perez MI, Musini VM | title = Pharmacological interventions for hypertensive emergencies | journal = The Cochrane Database of Systematic Reviews | issue = 1 | pages = CD003653 | date = January 2008 | volume = 2008 | pmid = 18254026 | doi = 10.1002/14651858.CD003653.pub3 | pmc = 6991936 }}</ref> The most affected organs include the brain, kidney, heart, and lungs, producing symptoms that may include [[confusion]], drowsiness, chest pain, and breathlessness.<ref name="Marik2007"/> In a hypertensive emergency, the blood pressure must be reduced more rapidly to stop ongoing organ damage;<ref name="Marik2007"/> however, there is a lack of [[randomized controlled trial]] evidence for this approach.<ref name=Perez/>