Over what period of time should blood pressure be lowered in a hypertensive urgency?

In a hypertensive urgency, the goal is to lower blood pressure gradually over several hours to avoid complications such as acute kidney injury, myocardial ischemia, or stroke. Unlike hypertensive emergencies, where immediate and aggressive treatment is necessary to prevent life-threatening events, hypertensive urgencies can be managed more slowly.

The preferred time frame for blood pressure reduction is typically within 24 hours, but many clinical guidelines suggest that a more gradual decrease over several hours is appropriate, allowing the body to adjust to the changes without significant adverse effects. Sustaining blood pressure in a controlled manner helps to minimize the risk of organ damage that can occur if the pressure is lowered too quickly.

Therefore, managing blood pressure within several hours provides a balance between the need to treat elevated levels effectively while still considering patient safety and overall health.