[Management of severe arterial XXXX ].

@entity1 @entity1580 @entity101 @entity3126
Severe arterial @entity101 is defined as a systolic blood pressure (BP) >= 180 mmHg and/or a diastolic BP >=  110 mmHg. Initial assessment is to identify acute, ongoing, target-organ damage such as @entity3126 , @entity1580 , ... ( @entity101 emergency). If so, the @entity1 requires urgent and specific management in a hospital setting. More commonly, however, BP in the severe range is relatively asymptomatic and not associated with end-organ damage ( @entity101 urgency). Management can usually be carried out in the ambulatory setting. Severe @entity101 should first be confirmed after a period of rest in a quiet room. If BP remains in the severe range, an antihypertensive drug can be initiated. Otherwise, the @entity1 should be referred for further evaluation within a few days ; however, an antihypertensive treatment could be started immediately if there is concern that urgent outpatient follow-up cannot be ensured or if the @entity1 is at high cardiovascular risk. The choice of the first drug should be tailored according to associated conditions and possible contraindications. Some guidelines recommend starting therapy with an antihypertensive combination of two drugs. In all cases, rapid and excessive reduction in BP, which could compromise organ perfusion, must be avoided, especially in elderly @entity1 . In the short-term (days), BP should be progressively lowered to < 160/100 mmHg. In the long term, a BP < 140/90 mmHg should be obtained.
