Contents
Hypertensive encephalopathy (HE) is general brain dysfunction due to significantly high blood pressure (> 200/130 mmHg)
- HYPERTENSIVE EMERGENCY

Aetiology
Causes of severe persistent hypertension:
- Kidney failure
- Rapidly stopping blood pressure medications
- Pheochromocytoma
- People on a monoamine oxidase inhibitor (MAOI) who eats foods with tyramine
- Pregnancy (eclampsia)
Pathophysiology
Hypertensive encephalopathy:

Clinical features
- Headache
- Vomiting
- Trouble with balance
- Confusion
Complications
- Seizures
- Posterior reversible encephalopathy syndrome
- Bleeding in the back of the eye
Management
Parenteral agents:
- Nitroprusside (arteriolar and venous dilator)
- Nicardipine (arteriolar dilator)
- Clevidipine (short-acting dihydropyridine CCB)
- Labetalol (α- & β-adrenergic blocker)
- Fenoldopam (peripheral dopamine-1 receptor agonist)
Oral agents:
Slower onset of action and an inability to control the degree of BP reduction (limited use in the therapy of hypertensive crises)
- Sublingual nifedipine
- Sublingual captopril
- Liquid nifedipine