Hypertensive Crisis in the Setting of Non-Compliance

Hypertension is a common chronic condition that affects approximately 78,000,000 adults within the United States [1]. Hypertensive crisis is defined as severe hypertension with a blood pressure of greater than 180/120 mmHg, and may be further classified as urgency or emergency [2,3]. Hypertensive urgency occurs in the setting of days to weeks and patients present most commonly with a headache. Hypertensive emergency occurs in hours to days and the patient presents with evidence of end organ failure and severe headache. Signs and symptoms of end organ failure are listed in (Table 1). An estimated 7% of patients progress to hypertensive emergency prior to being prescribed antihypertensive therapy and 1 to 2% will progress while treated with anti-hypertensive therapy during their lifetime [2,4]. The mortality rate, if hypertensive emergency remains untreated, at 1 and 5 years is 70 to 90% and 100% respectively.