The difference between hypertensive crisis and hypertensive encephalopathy

Written by Wang Ji Zhong
Internal Medicine
Updated on August 31, 2024
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Both hypertensive encephalopathy and hypertensive crisis involve a rapid increase in blood pressure, symptoms of headache, restlessness, nausea and vomiting, palpitations, shortness of breath, and blurred vision, with systolic pressure increasing to 200 mmHg and diastolic pressure to 120 mmHg, typically presenting similar clinical blood pressure readings. The main difference between the two is that hypertensive encephalopathy is based on excessively high blood pressure in patients with severe hypertension. Furthermore, hypertensive encephalopathy can lead to clinical signs of cerebral edema and increased intracranial pressure, whereas hypertensive crisis occurs when blood pressure suddenly rises over a short period, causing symptoms due to excessive secretion of catecholamines driven by increased sympathetic nervous excitement.

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Written by Li Hai Wen
Cardiology
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Normal blood pressure, high blood pressure, and low blood pressure ranges.

Normal adult systolic blood pressure is between 90-139mmHg, and diastolic pressure is between 60-89mmHg. When the systolic pressure exceeds 140mmHg and the diastolic pressure exceeds 90mmHg, this condition is medically referred to as hypertension. When the systolic pressure is below 90mmHg and the diastolic pressure is below 60mmHg, this condition is medically referred to as hypotension. Regardless of whether it is hypertension or hypotension, it often causes symptoms in patients, such as headache, dizziness, and fatigue. Therefore, whether it is hypertension or hypotension, one should visit the hospital's department of cardiology for a formal examination. The doctor will assess the situation on-site to determine if treatment is necessary and how to administer it.

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Written by Zhang Yue Mei
Cardiology
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What to eat for high blood pressure

Patients with hypertension need to regularly take antihypertensive medication to bring their blood pressure within the normal range. In daily life, dietary adjustments should be made, avoiding foods high in fats such as fatty meat from animals, offal, fried foods, and sweets. Instead, consume more vegetables high in dietary fiber, vitamins, and trace minerals. Suitable vegetables for people with hypertension include celery, spinach, mung bean sprouts, black fungus, water chestnuts, onions, carrots, winter melon, and Chinese cabbage.

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Written by Wei Shi Liang
Intensive Care Unit
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How to deal with hypertensive emergencies

Hypertensive emergency is characterized by a significant increase in blood pressure, often with diastolic pressure greater than 130 mmHg. Target organs including the brain, eyes, heart, and kidneys are severely compromised or fail. Hypertensive emergencies require admission to the CCU for cardiac monitoring and the use of intravenous antihypertensives. In the initial one to two hours, the reduction in blood pressure should not exceed 25% of the peak value. Control blood pressure within two to six hours and stabilize it at 160/100 mmHg. Commonly used antihypertensive drugs include sodium nitroprusside and nitroglycerin, while avoiding the use of nifedipine-like drugs for blood pressure reduction.

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Written by Tang Li
Cardiology
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What is hypertension?

Hypertension is characterized by elevated arterial blood pressure in the systemic circulation, and may be accompanied by functional or organic damage to organs such as the heart, brain, and kidneys. Hypertension can be divided into primary hypertension and secondary hypertension. Secondary hypertension is due to certain identified causes or etiologies, leading to increased blood pressure, accounting for about 5% of all hypertension cases. Conditions like primary aldosteronism, pheochromocytoma, renovascular hypertension, and renin-secreting tumors are examples, and cases where the cause of increased blood pressure cannot be found are also referred to as primary hypertension and hypertensive disease. Currently, the classification and standard for blood pressure in China mostly use a systolic pressure of greater than or equal to 140 mmHg and/or a diastolic pressure of greater than or equal to 90 mmHg.

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Written by Zhou Yan
Geriatrics
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Difference between hypertensive crisis and hypertensive encephalopathy

Hypertensive crisis, now referred to as hypertensive emergency, includes hypertensive encephalopathy. It mainly refers to cases where, under certain triggers, the blood pressure of patients with primary or secondary hypertension suddenly or significantly rises, typically exceeding 180/120 mmHg, accompanied by progressive failure of critical target organs such as the heart, brain, and kidneys. Hypertensive emergencies include hypertensive encephalopathy, cerebral hemorrhage, cerebral infarction, acute heart failure, acute coronary syndrome, aortic dissection, etc. Hypertensive encephalopathy is characterized by symptoms caused by hypertension, such as headache, blurred vision, nausea, vomiting, and severe edema of the head.