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Q. What is hypertensive urgency?

Answered by
Dr. Amit Arora
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 24, 2016 and last reviewed on: Oct 09, 2018

Hi doctor,

I am a 55 year old male. I am diabetic for the past 15 years and I also have high BP. Before 20 to 25 days, while walking I felt like dizziness and I could not climb the staircase. Before my BP was 240/140 mmHg, but now it is 160/100 mmHg. Later on the creatinine and blood urea was also more. Now, my BP is 160/100 mmHg. As the day proceeds by evening I feel unstable and feel uneasy then BP increases to 190/110 mmHg or more. Yesterday night, I felt like a paralytic stroke of my left leg while sleeping, but any how suddenly got up and I was safe. My current medication is tablet Telma 40 mg, tablet Telma 20 mg and tablet Amlong in the morning and at night respectively. For diabetes, my current medication is tablet Glycomet GP2 both in the morning and night. Presently, I am not taking any Insulin due to controlled sugar. I am attaching my blood test report. Please advise some medications if any keeping in view of the above reports.

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Hi,

Welcome to icliniq.com.

  • It seems that you have accelerated hypertension (attachment removed to protect patient identity).
  • Blood pressure (BP) shoots around 250/140 mmHg, this we called as hypertensive urgency. It could lead to hemorrhagic stroke which could be fatal. Anyway, you are lucky.
  • You felt like a paralytic stroke of the leg, which got resolved. You need a proper evaluation in the form of history and investigations.
  • Your renal function test are not seems to be fine and prolonged diabetes can cause kidney disease.
  • I need to ask a few questions. Since how long you have been suffering from BP? And when did you start taking medications for high BP?
  • How long you are suffering from diabetes and how long you are on medication for diabetes?
  • You have any smoking or alcohol consuming history? Are you an active worker?
  • Do you have any complaints of shortness of breath in the past or present, chest pain in the past or recurrent pain in the chest get relieved by resting?
  • Any associated chronic disease or any complaint of palpitation or sweating over the body or legs?
  • Right now, no need to worry as you are lucky. But, from now you must start caring about yourself as both diabetes and hypertension with poor renal function are suggesting of impending problems if neglected.
  • Treatment plan:
  1. Continue with same medicines, but get your BP and sugar monitored regularly.
  2. Switch over to Telma H (combination of Telmisartan and Hydrochlorothiazide) instead of plain Telma, if you have swelling over the feet or shortness of breath.
  3. Add multivitamins and get an NCCT- noncontrast CT scan of the head done to rule out any neurological deficit.
  4. Get RFT (renal function test) and upload the reports.
  5. Get HbA1c- hemoglobin A1c test along with fasting and postprandial sugar test done.
  6. Complete urine examination, lipid profile and USG (ultrasound sonography test) to check out the combination of kidney.

The Probable causes:

High uncontrolled BP and sugar.

Investigations to be done:

Get an NCCT, RFT, HbA1c, fasting and postprandial sugar test, complete urine examination and USG test done.

Preventive measures:

Lifestyle modification as follows:
1. Reduce salt, sugar and fatty food.
2. Do mediation and some breathing exercises.

Regarding follow up:

Revert back with the test reports and answers to the above questions to an internal medicine physician online.---> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician


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