The blood pressure of normal people or hypertensive patients suddenly or obviously rises, even exceeding 180/ 120mmHg, which may be accompanied by sexual dysfunction of important target organs such as heart, brain and kidney. In this case, it is necessary to control the blood pressure within a certain range as soon as possible, but it cannot suddenly drop to normal, otherwise the perfusion pressure of important organs will suddenly drop, which will lead to the aggravation of the disease.
Reduce blood pressure to 1 hour in time within the first few minutes: intravenous medication can be selected, and the goal of blood pressure control is to reduce the average arterial pressure by no more than 25% of the pre-treatment level. Drugs with quick onset, short action time and little adverse reaction should be selected. Commonly used drugs such as sodium nitroprusside, nitroglycerin, urapidil, etc.
In the following 2~6 hours, the blood pressure will drop to a safe level: generally around 160/ 100mmHg, and the patient will feel good about himself, and there will be no new symptoms such as dizziness, headache, nausea and vomiting. Intravenous medication can be continued, and the dosage of antihypertensive drugs can be adjusted as appropriate.
24-48 hours: Blood pressure gradually approaches or drops to normal level. If palpitation, decreased urine volume and head discomfort occur, the speed and extent of blood pressure drop can be slowed down. It is suggested to add oral long-acting and stable antihypertensive drugs, such as nifedipine controlled-release tablets, amlodipine, benazepril, fosinopril and losartan. Start with a small dose.
4. In the following 1~2 weeks: according to the blood pressure and the clinical manifestations of patients, long-acting and stable antihypertensive drugs can be gradually added to keep the blood pressure within the normal range.
Rapid blood pressure reduction should be based on the patient's blood pressure and condition, so that blood pressure can be reduced to a safe range, and blood pressure can be reduced in a timely and controlled manner, which can alleviate the patient's condition as soon as possible, improve the prognosis and improve the quality of life. On this basis, transition to long-term stable blood pressure control.