How should severe uncontrolled hypertension be defined for the purposes of relative contraindications to fibrinolytics?

Severe uncontrolled hypertension is an important consideration when determining contraindications for fibrinolytic therapy, especially in the context of acute myocardial infarction or stroke. The standard definition for severe hypertension in this scenario is a blood pressure greater than 180/110 mm Hg. This threshold is established because such elevated levels significantly increase the risk of complications, including intracranial hemorrhage or other bleeding events, when fibrinolytics are administered. Therefore, choosing a definition that aligns with this standard is crucial for ensuring patient safety while considering treatment options.

Higher thresholds indicate a greater level of risk, and defining severe uncontrolled hypertension accurately is vital to minimize potential adverse outcomes associated with fibrinolytic therapy. This understanding is central to critical care support practices where quick and effective treatment must be weighed against potential harms.