Praew Kotruchin1, Thapanawong Mitsungnern2, Ratkamon Ruangsaisong2, Supap Imoun2,3, Chatlert Pongchaiyakul4. 1. Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. kpraew@kku.ac.th. 2. Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. 3. Emergency Nursing Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. 4. Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand.
Abstract
INTRODUCTION: Hypertensive (HT) urgency is a common presentation in emergency room (ER). Although the practice guideline recommends against rapid blood pressure (BP) reduction, in medical practice, physicians usually attempt to timely reduce BP in order to avoid target organ damage. However, there is limited data in Asians. This study was designed to fill the gap of knowledge by using the dataset of the HT crises patients at a tertiary care center. AIM: To determine the characteristics, treatments, and outcomes of HT urgency patients during ER visit and at 2-week follow-up. METHODS: A retrospective cohort study conducted at a university hospital in northeast Thailand from January 2012 to June 2017. Hypertensive crises patients were consecutively enrolled. RESULTS: Of the 221,287 patients who admitted to the ER, prevalence rates of HT urgency and HT emergency were 48.5 and 15.5 per 100,000 patients-year. In HT urgency cases, the average initial and discharge SBP/DBP were 200/110 and 163/92 mmHg, respectively. Oral anti-HT medications were most frequently prescribed (90.5%). At a 2-week follow-up, 24.6% of patients had BP < 140/90 mmHg. The SBP at ER discharge was significantly lower in the patients with follow-up BP < 140/90 compared to those with BP > 140/90 mmHg (158.8 ± 16.9 vs. 164.2 ± 16.6 mmHg, P < 0.01). CONCLUSIONS: Hypertensive urgency was common among patients admitted to the ER. Oral anti-HT medication effectively reduced BP. One in five patients had BP < 140/90 mmHg at a 2-week follow-up and systolic BP at discharge might be an important factor in predicting better BP control.
INTRODUCTION:Hypertensive (HT) urgency is a common presentation in emergency room (ER). Although the practice guideline recommends against rapid blood pressure (BP) reduction, in medical practice, physicians usually attempt to timely reduce BP in order to avoid target organ damage. However, there is limited data in Asians. This study was designed to fill the gap of knowledge by using the dataset of the HT crises patients at a tertiary care center. AIM: To determine the characteristics, treatments, and outcomes of HT urgency patients during ER visit and at 2-week follow-up. METHODS: A retrospective cohort study conducted at a university hospital in northeast Thailand from January 2012 to June 2017. Hypertensive crises patients were consecutively enrolled. RESULTS: Of the 221,287 patients who admitted to the ER, prevalence rates of HT urgency and HT emergency were 48.5 and 15.5 per 100,000 patients-year. In HT urgency cases, the average initial and discharge SBP/DBP were 200/110 and 163/92 mmHg, respectively. Oral anti-HT medications were most frequently prescribed (90.5%). At a 2-week follow-up, 24.6% of patients had BP < 140/90 mmHg. The SBP at ER discharge was significantly lower in the patients with follow-up BP < 140/90 compared to those with BP > 140/90 mmHg (158.8 ± 16.9 vs. 164.2 ± 16.6 mmHg, P < 0.01). CONCLUSIONS:Hypertensive urgency was common among patients admitted to the ER. Oral anti-HT medication effectively reduced BP. One in five patients had BP < 140/90 mmHg at a 2-week follow-up and systolic BP at discharge might be an important factor in predicting better BP control.
Authors: Patricia M Kearney; Megan Whelton; Kristi Reynolds; Paul Muntner; Paul K Whelton; Jiang He Journal: Lancet Date: 2005 Jan 15-21 Impact factor: 79.321
Authors: Paul K Whelton; Robert M Carey; Wilbert S Aronow; Donald E Casey; Karen J Collins; Cheryl Dennison Himmelfarb; Sondra M DePalma; Samuel Gidding; Kenneth A Jamerson; Daniel W Jones; Eric J MacLaughlin; Paul Muntner; Bruce Ovbiagele; Sidney C Smith; Crystal C Spencer; Randall S Stafford; Sandra J Taler; Randal J Thomas; Kim A Williams; Jeff D Williamson; Jackson T Wright Journal: Hypertension Date: 2017-11-13 Impact factor: 10.190