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February 1989

How Urgent Is 'Urgent' Hypertension?

Arch Intern Med. 1989;149(2):257-258. doi:10.1001/archinte.1989.00390020007001

Public health efforts over the past 20 years to detect and to treat elevated arterial pressure have resulted in a sharp decrease in the prevalence of accelerated or malignant hypertension. As a result, the presentation See also p 260. of patients with hypertensive "emergencies," ie, situations requiring hospitalization and immediate blood pressure reduction with parenteral medications, is an uncommon event.1 In recent years, the term hypertensive "urgency" has evolved denoting a situation where a marked elevation in blood pressure (eg, ≥130 mm Hg diastolic), though not associated with immediate endorgan damage, is believed to require reduction within 24 hours to minimize potential patient risk.2 In this issue of the Archives, Jaker and colleagues3 describe their comparison of nifedipine and clonidine in the treatment of urgent hypertension in an inner city emergency room. Their study is rare in that it applied a double-blind, randomized treatment design in this