Clinical profile of patients with hypertensive emergencies in a tertiary care hospital

Authors

  • S. Narasimha Murty Department of General Medicine, Government Medical College, Srikakulam, Andhra Pradesh, India
  • S. S. V. V. Narsinga Rao Department of General Medicine, Government Medical College, Srikakulam, Andhra Pradesh, India
  • A. S. Veeramani Kartheek Department of General Medicine, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20232409

Keywords:

Hypertensive emergencies, Hypertension, Target organ damage

Abstract

Background: Hypertensive emergency is defined by systolic blood pressure (SBP) ≥180 mmHg and/or diastolic blood pressure (DBP) ≥120 mmHg with acute target organ damage. Hypertensive emergencies can be life threatening and fatal unless timely treated. In the present study we aim to study the clinical profile and outcome of patients admitted with hypertensive emergency in the medical intensive care unit in our hospital.

Methods: A cross-sectional observational study of all cases with hypertensive emergency admitted in Medical Intensive care unit (ICU) in Government General Hospital, Srikakulam during the study period was conducted. The clinical profile and outcome of the patients were assessed.

Results: Out of the fifty patients in the present study, about 36 (72%) were males and 14 were females (28%) and about one third of the patients (36%) belonged to the age group of 60-69 years. Diabetes mellitus (30%) and dyslipidemia (40%) were the commonly encountered comorbidities in the study population. Most frequent presenting symptoms were neurological deficits (50%) followed by dyspnoea (32%) and chest pain (24%). Intracerebral haemorrhage was the commonest target organ damage found in 30% of the patients. Patients presenting with hypertensive emergencies with neurological target organ damage had statistically significant increased chance of mortality (p=0.007).

Conclusions: As hypertension emergencies are consequence of uncontrolled hypertension, it is important to educate and bring awareness among public regarding the screening, early detection, and adherence to prescribed medication for hypertension to avoid adverse clinical outcomes.

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References

Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Himmelfarb CD, et al. 2017 ACC /AHA /AAPA /ABC /ACPM /AGS /APhA/ASH/ASPC/ NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:e127-e48.

Kotruchin P, Tangpaisarn T, Mitsungnern T, Sukonthasarn A, Hoshide S, Turana Y, et al. Hypertensive emergencies in Asia: A brief review. J Clin Hypertens (Greenwich). 2022;24(9):1226-35.

Dhadke SV, Dhadke VN, Batra DS. Clinical Profile of Hypertensive Emergencies in an Intensive Care Unit. J Assoc Physicians India. 2017;65(5):18-22.

Rossi GP, Rossitto G, Maifredini C, Barchitta A, Bettella A, Latella R, et al. Management of hypertensive emergencies: a practical approach. Blood Press. 2021;30(4):208-19.

Martin JFV, Higashiama E, Garcia E, Luizon MR, Cipullo JP. Hypertensive crisis profile: prevalence and clinical presentation. Arch Bras Cardiol. 2004;83(2).

Messerli FH, Garavaglia GE, Schmieder RE, Sundgaard-Riise K, Nunez BD, Amodeo C. Disparate cardiovascular findings in men and women with essential hypertension. Ann Intern Med. 1987;107(2):158-61.

Owens JF, Stoney CM, Matthews KA. Menopausal status influences ambulatory blood pressure levels and blood pressure changes during mental stress. Circulation. 1993;88(6):2794-802.

Kotruchin P, Pratoomrat W, Mitsungnern T, Khamsai S, Imoun S. Clinical treatment outcomes of hypertensive emergency patients: results from the hypertension registry program in Northeastern Thailand. J Clin Hypertens. 2021;23:621-7.

Kim BS, Kim H-J, Lyu M, Kim W-D, Lee Y, Kim M, et al. Clinical characteristics, practice patterns, and outcomes of patients with acute severe hypertension visiting the emergency department. J Hypertens. 2021;39:2506-13.

Almas A, Ghouse A, Iftikhar AR, Khursheed M. Hypertensive crisis, burden, management, and outcome at a tertiary care center in Karachi. Int J Chronic Dis. 2014;1-7.

Lugito NPH, Kurniawan A, Yanto TA, Saputro IO. Hypertensive crisis: epidemiological, clinical profile and management at emergency unit of general hospital in Tangerang, Banten, Indonesia. In Proceedings of the 1st International Conference on Global Health, Jakarta, Indonesia. KNE Publishing. 2017.

Zampaglione B, Pascale C, Marchisio M, Cavallo-Perin P. Hypertensive urgencies and emergencies. Prevalence and clinical presentation. Hypertension. 1996;27(1):144-7.

Sowers JR, Epstein M. Diabetes mellitus and associated hypertension, vascular disease, and nephropathy. An update. Hypertension. 1995;26(6 Pt 1):869-79.

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Published

2023-07-29

How to Cite

Murty, S. N., Rao, S. S. V. V. N., & Veeramani Kartheek, A. S. (2023). Clinical profile of patients with hypertensive emergencies in a tertiary care hospital. International Journal of Research in Medical Sciences, 11(8), 2837–2842. https://doi.org/10.18203/2320-6012.ijrms20232409

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Original Research Articles