🔴 درمانِ Emergent Hypertension:

⚠️ Goal: Reduce BP gradually to avoid organ hypoperfusion

1️⃣ First hour: Lower mean arterial pressure (MAP) by no more than 20–25% (e.g., from 200/120 mmHg to ~160/100 mmHg)

2⃣ Next 2–6 hours: Aim for 160/100–110 mmHg

3️⃣ 24–48 hours: Gradually normalize BP to target levels (e.g., <140/90 mmHg)

⚠️ Organ-Specific Targets:

— Aortic dissection: Systolic BP <120 mmHg (using IV beta-blockers + vasodilators)

— Stroke (ischemic): Lower BP only if >220/120 mmHg; reduce by 10–15%

— Stroke (hemorrhagic): Target systolic BP <140 mmHg if safe

— Acute kidney injury/Pulmonary edema: Reduce BP by 10–25% initially

⚠️ Agents: IV drugs (e.g., nicardipine, labetalol, nitroprusside,...).

Labetalol

In general, reduce mean arterial blood pressure gradually by ~10% to 20% over the first hour, then by an additional 5% to 15% over the next 23 hours, unless there is a compelling indication (eg, acute aortic dissection, severe preeclampsia, eclampsia) for more rapid blood pressure and heart rate control.

Intermittent IV:
Initial: 10 to 20 mg over 1 to 2 minutes followed by 20 to 80 mg every 10 minutes until target blood pressure is reached.

No Renal or Hepatic adjustment is needed.

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