Background: Cardiovascular diseases (CVD) are the number one cause of death globally
compared to any other cause. CVD accounts for approximately 17.3 million deaths per year and are
rising. Hypertension is the leading risk factor for cardiovascular diseases. Approximately, 80 million
people suffer from hypertension in the U.S. While, majority of these individuals are on
antihypertensive medications only 54% of individuals with hypertension are optimally controlled.
Heart failure and stroke are some of the devastating complications of uncontrolled hypertension.
Hypertensive crisis can be classified as either an urgency or emergency; difference between the two is
the presence of end organ damage, which is noted in hypertensive emergency. Hypertensive crisis is
usually treated by parenteral antihypertensive medications. The main drug classes of drugs for treatment
are nitrates, calcium channel blockers, dopamine-1 agonists, adrenergic-blocking agents etc.
Conclusion: In this review, we discuss approach to management of hypertensive crisis and each drug
class with its physiology and complications.