Table 10 BIHS position: Considerations for blood pressure (BP) lowering therapy in acute coronary syndrome (ACS).
From: Management of hypertensive crisis: British and Irish Hypertension Society Position document
Hypertensive emergency state | Acute coronary syndrome |
|---|---|
Speed of BP reduction and BP targets | 1. Routine immediate reduction in BP is not recommended. Adequate analgesia and maintenance of oxygenation are first steps |
2. Prioritise revascularisation therapy over BP therapy | |
3. Reduce BP as indicated by clinical scenario (example as per procedural requirements in the cardiac catheterisation laboratory) in patients with ACS. Do not reduce DBP below 70 mmHg. | |
4. All patients should have plans drawn for long term hypertension management (<140/90 mmHg prior to discharge). | |
Medications | IV GTN and/or IV labetalol may be used. Nitroprusside to be avoided in ACS. |
