Clinical aspects and main procedures performed in hypertensive urgencies and emergencies: a narrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i14.35825

Keywords:

Hypertensive emergency; Hypertensive crisis; Hypertension; Nursing.

Abstract

Hypertensive crisis is a significant clinical entity with considerable mortality and morbidity, with organ damage in many patients, a factor that significantly hinders quality of life. In view of this, the importance of urgent and emergency care plan in situations of hypertensive crisis is highlighted, in order to ensure immediate care that can offer a rapid and gradual reduction in blood pressure levels. The objective of the study was to offer a brief narrative review on the approach of the hypertensive crisis in the face of the terminologies 'hypertensive urgency' and 'hypertensive emergency', in order to understand the clinical aspects and the main conducts performed in the care, articulating with the performance of the professional nurse facing this clinical condition. This research was elaborated from a bibliographic survey in the scientific databases of the Scientific Electronic Library Online (SCIELO), Latin American and Caribbean Literature on Health Sciences (LILACS), Google Scholar and Virtual Health Library (VHL), with publications between 2015 and 2020 as a temporal delimitation. In view of the results obtained, it was found that all articles presented an approach to hypertensive crisis in urgency and emergency services. Noting that both hypertensive crisis terminologies are used, as well as the terms 'hypertensive urgency' and 'hypertensive emergency,' to present the peculiarities and relevant results about each condition. It is also important to highlight the need for better care by the nursing team, mainly because they deal directly and frequently with patients, using risk classification as an essential tool in redirecting the flow of care in urgent and emergency services. The demands of hypertensive crisis in the urgency and emergency sector signal the need to improve local health promotion and prevention actions, with primary health care playing a fundamental role in the development of these strategies.

References

Abdallah, T. M., Ibrahem, A. A., Ali, E. A., Ahmed, E. G., & Ali, A. A. (2018). Clinico-epidemiological characteristics and survival outcome of patients with hypertensive crisis at Kassala Hospital, Eastern Sudan. J. Clin. Intensive Care Med., 3 (1), 029-034. https://www.heighpubs.org/jcicm/pdf/jcicm-aid1017.pdf.

Almeida, A. B. D., Vanoni, N. B., & Zeferino, M. G. M. (2018). O papel da enfermagem no atendimento ao paciente em emergência e urgência hipertensiva. Revista de Iniciação Científica da Libertas, 8, (1), 58-69. http://www.libertas.edu.br/revistas/index.php/riclibertas/article/view/98.

Barbosa, J. de S., Pimentel, A. C. E., Costa, L. B. D. da., Camacho, A. C. L. F., & Correia, D. M. da S. (2020). The impact of acupuncture in the treatment of systemic arterial hypertension. Research, Society and Development, 9(11), e2079119752. https://doi.org/10.33448/rsd-v9i11.9752

Bello, L. B. G., Pederzani, L. M., Fretes, A., & Centurión, O. A. (2020). Características clínicas de los pacientes con crisis hipertensivas que acuden a un Servicio de emergencias médicas. Rev. virtual Soc. Parag. Med. Int., 7 (1), 42-49. https://www.revistaspmi.org.py/index.php/rvspmi/article/view/154.

Benenson, I., Waldron, F. A., Jadotte, Y. T., & Holly, C. (2019). Risk factors for hypertensive crisis in adult patients: a systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports, 17 (11), 2343–2349. https://pubmed.ncbi.nlm.nih.gov/31246735/.

Chaudhary, D., & Lakhani, K. (2019). Study of clinical profile of patients with hypertensive crisis. International Journal of Scientific Research, 8 (2), 45-48. https://www.worldwidejournals.com/international-journal-of-scientific-research-(IJSR)/fileview.php?val=February_2019_1549017701__18.pdf.

Demézio, D. C. D. S., Milhomes, F. F., & Brasileiro, M. E. (2013). O Enfermeiro frente à crise hipertensiva no atendimento de urgência e emergência. Revista Eletrônica de Enfermagem do Centro de Estudos de Enfermagem e Nutrição, 4 (4), 1-15. https://docplayer.com.br/19645479-O-enfermeiro-frente-a-crise-hipertensiva-no-atendimento-de-urgencia-e-emergencia-1.html.

Lee, G. H., Lee, I. R., Park, S. J., Kim, J. H., Oh, J. Y., & Shin, J. I. (2016). Hypertensive crisis in children: an experience in a single tertiary care center in Korea. Clinical Hypertension, 22 (10), 1-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834822/pdf/40885_2016_Article_40.pdf.

Kaya, A., Tatlisu, M. A., Pharm, T. K. K., Yildirimturk, O., Gungor, B., Karatas, B., Yazici, S., Keskin, M., Avsar, S., & Murat, A. (2016) Sublingual vs. oral captopril in hypertensive crisis. The Journal of Emergency Medicine, 50 (1), 108–115. https://www.sciencedirect.com/science/article/abs/pii/S0736467915007921#:~:text=Captopril%2C%20a%20popular%20drug%20for,difference%20equalized%20at%2060%20min.

Kubotani, K. P. S., Fernandes, D. R., & Terra J. A. T. (2019). Utilização de fármacos vasodilatadores de ação direta e indireta no tratamento de hipertensão arterial: artigo de revisão. Revista da Faculdade de Educação e Meio Ambiente, 10 (1), 148-155. https://revista.faema.edu.br/index.php/Revista-FAEMA/article/view/775/780.

Mendes, F. D. A., Silva, M. P. D., & Ferreira, C. R. S. (2018). Diagnósticos de enfermagem em portadores de hipertensão arterial na atenção primária. Estação científica (UNIFAP), 8 (1), 91-101. https://periodicos.unifap.br/index.php/estacao/article/view/3482.

Mello, A. B. Q. B., Alvarez, E. T., Moreira, F. B. S., Costa, G. R., & Junior, H. L. S. (2018). Como se portar frente a emergência hipertensiva. Revista Caderno de Medicina, 1 (1), 24-33. https://www.unifeso.edu.br/revista/index.php/cadernosdemedicinaunifeso/article/view/952.

Oliveira, S. G. D., & Silva, L. L D. (2016). O papel da equipe de enfermagem frente ao paciente em crise hipertensiva. Revista Saúde e Desenvolvimento, 10 (5), 180-195. https://www.revistasuninter.com/revistasaude/index.php/saudeDesenvolvimento/article/view/600/353.

Paini, A., Aggiusti, C., Bertacchini, F., Rosei, C. A., Maruelli, G., Arnoild, C., Cappellini, S., Muiesan, M. L., & Salvetti, M. (2018). Definitions and Epidemiological Aspects of Hypertensive Urgencies and Emergencies. High Blood Press Cardiovasc. Prev, 25, 241–244. https://link.springer.com/article/10.1007/s40292-018-0263-2.

Pierin, A. M. G., Flórido, C. F., & Santos, J. D., (2019). Crise hipertensiva: características clínicas de pacientes com urgência, emergência e pseudocrise hipertensivas em um serviço público de emergência. Einstein, 17 (4), 1-8. https://journal.einstein.br/pt-br/article/crise-hipertensiva-caracteristicas-clinicas-de-pacientes-com-urgencia-emergencia-e-pseudocrise-hipertensivas-em-um-servico-publico-de-emergencia/.

Rother, E. T. (2007). Revisão sistemática X revisão narrativa. Acta Paulista de Enfermagem, 20 (2). https://www.scielo.br/j/ape/a/z7zZ4Z4GwYV6FR7S9FHTByr/.

Santos, C. de S., & Pol-Fachin, L. (2022). Systemic Arterial Hypertension in the Family Health Strategy: a literature review. Research, Society and Development, 11(13), e09111332281. https://doi.org/10.33448/rsd-v11i13.32281

Seeman, T., Hamdani, G., & Mitsnefes, M. (2019). Hypertensive crisis in children and adolescents. Pediatric Nephrology, 34, 2523–2537. https://pubmed.ncbi.nlm.nih.gov/30276533/.

Shao, P. J., Sawe, H. R., Murray, B. L., Mfinanga, J. A., Mwafongo, V., & Runyon, M. S. (2018). Profile of patients with hypertensive urgency and emergency presenting to an urban emergency department of a tertiary referral hospital in Tanzania. BMC Cardiovascular Disorders, 18 (158), 1-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6090910/pdf/12872_2018_Article_895.pdf.

Siqueira, D. S., Riegel, F., Tavares, J. P., Crossetti, M. D. G. O., Goes, M. G. O. D., & Arruda, L. S. (2015). Caracterização dos pacientes atendidos com crise hipertensiva num hospital de pronto socorro. Revista de Enfermagem Referência, 4 (5), 27-36. https://www.lume.ufrgs.br/bitstream/handle/10183/129684/000975502.pdf?sequence=1.

Sousa, M. G., & Passarelli, J. O. (2014). Emergências hipertensivas: epidemiologia, definição e classificação. Rev. Bras. Hipertens., 21 (3), 134-139. https://docs.bvsalud.org/biblioref/2018/03/881333/rbh_v21n3_134-139.pdf.

Stein, D. R., & Ferguson, M. A. (2016). Evaluation and treatment of hypertensive crises in children. Integrated Blood Pressure Control, 9, 49–58. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4803257/.

Suneja, M., & Sanders, M. L. (2017). Hypertensive Emergency. Medical Clinics of North America, 101 (3), 465–478. https://pubmed.ncbi.nlm.nih.gov/28372707/.

Wan, S., Joshua, Slusser, J. P., Hodge, D. O., & Chen, H. H. (2018). The Vascular-Renal Connection in Patients Hospitalized With Hypertensive Crisis: A Population-Based Study. Mayo Clin. Proc. Inn Qual. Out, 2 (2), 148-154. https://www.researchgate.net/publication/323786586_The_VascularRenal_Connection_in_Patients_Hospitalized_With_Hypertensive_Crisis_A_PopulationBased_Study/link/5ba1aecea6fdccd3cb61ff8d/download.

Published

22/10/2022

How to Cite

SOUZA, D. G. de .; OLIVEIRA, G. R. .; CUNHA, C. M. B.; BORGES, M. B. S. .; MACIEL, M. X. .; OLIVEIRA, P. R. de .; MARTINS, M. das N. .; BRANDÃO, V. P.; COSTA, N. B. M. .; MENEZES, L. S. . Clinical aspects and main procedures performed in hypertensive urgencies and emergencies: a narrative review. Research, Society and Development, [S. l.], v. 11, n. 14, p. e154111435825, 2022. DOI: 10.33448/rsd-v11i14.35825. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/35825. Acesso em: 14 nov. 2024.

Issue

Section

Review Article