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Jgc 15 07 504

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Joliet Junior College
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Journal of Geriatric Cardiology (2018) 15: 504512 ©2018 JGC All rights reserved; www.jgc301.com Review  Open Access  Management of hypertensive crises in the elderly Abbas Alshami1, 2, Carlos Romero1, 3, America Avila1, 4, Joseph Varon5, 6, 7 1 Dorrington Medical Associates, Houston, Texas, USA University of Baghdad/College of Medicine, Baghdad, Iraq 3 Universidad Autónoma de San Luis Potosí, San Luis Potosí, México 4 Universidad Durango Santander, Hermosillo, Sonora, México 5 The University of Texas Health Science Center at Houston, USA 6 The University of Texas Medical Branch at Galveston, USA 7 Critical Care Services, United Memorial Medical Center / United General Hospital, Houston, Texas, USA 2 Abstract Hypertensive crises are elevations of blood pressure higher than 180/120 mmHg. These can be urgent or emergent, depending on the presence of end organ damage. The clinical presentation of hypertensive crises is quite variable in elderly patients, and clinicians must be suspicious of non-specific symptoms. Managing hypertensive crises in elderly patients needs meticulous knowledge of the pathophysiological changes in them, pharmacological options, pharmacokinetics of the medications used, their side effects, and their interactions with other medications. Clevidipine, nicardipine, labetalol, esmolol, and fenoldopam are among the preferred choices in the elderly due to their efficacy and tolerability. Nitroprusside, hydralazine, and nifedipine should be ...
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