UNCONTROLLED HYPERTENSION AND HYPERTENSIVE URGENCY – ONE YEAR SINGLE CENTER EMERGENCY DEPARTMENT EXPERIENCE

• DOI: 10.1097/01.hjh.0001021936.09613.26
• Publication Date: 2024-05-22T10:10:38Z
• Authors: Jakub Nowicki; Wojciech Silka; Aleksandra Zalust...; Marek Rajzer; Agnieszka Olszanecka
• Keywords: Center (category theory); Hypertensive emergency; Single Center

Objective: Background: Elevated blood pressure (BP) is a frequent cause of admittance to the Emergency Department (ED). Since this group patients characterized by great heterogeneity, considerable efforts were put stratify them according medical state severity and corresponding prognosis. Little known about cohort patients, which in light their substantial volume burden pose significant challenge for physicians at EDs Aim: To characterize admitted an ED elevated BP evaluate factors associated with hospitalization. Design method: Methods: This retrospective analysis comprised all (N=578) university hospital 2022 due acute rise exclusion hypertensive emergencies. Results: The studied constituted 1.5% visits 2022. median age was 67 years; 69% females. Headache, vertigo (36.3%), chest pain (26.8%) as well shortness breath (11.4%), neurological deficits (10.9%) most common complaints, however every fifth patient asymptomatic (22.8%). Median SBP (200 mmHg, n=346) diastolic BPs (DBP) (105 n=316) measured home significantly higher than (173 mmHg n=578) DBP (95 during triage (p<0.0001). BP-lowering agents prior admission taken 38.6% patients. In vast majority captopril used prehospital lowering agent (91%). nitrendipine administrated 53.5% being administered often (37.5%), whereas furosemide (16.1%), urapidil (9.9%), nitroglycerine (1.9%) less likely. Eventually, SBP/DBP 140/82 reached 289 minutes spent ED, i.e. approximately 5 hours. Hospitalization necessary 5.4% 40% underwent antihypertensive treatment adjustment. Multivariable regression revealed that arterial (MAP) not hospitalization, however, (odds ratio (OR), 2.2, p<0.01) or administration (OR, 1.999, increased such risk. Conclusions: Improvements pre-ED management long-term hypertension may reduce seeking without end-organ damage.