Clinical characteristics and prognosis of patients with very severe acute hypertension visiting the emergency departmentopen access
- Authors
- Kim, Hyun-Jin; Kim, Byung Sik; Shin, Jeong-Hun
- Issue Date
- Aug-2022
- Publisher
- SPRINGERNATURE
- Keywords
- Very severe acute hypertension; Emergency department; Hypertension-mediated organ damage; Mortality
- Citation
- CLINICAL HYPERTENSION, v.28, no.1, pp.1 - 9
- Indexed
- SCOPUS
KCI
- Journal Title
- CLINICAL HYPERTENSION
- Volume
- 28
- Number
- 1
- Start Page
- 1
- End Page
- 9
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/171548
- DOI
- 10.1186/s40885-022-00208-3
- ISSN
- 2635-6325
- Abstract
- Background
Data regarding very severe acute hypertension, a serious problem in emergency departments (EDs), are scarce. We investigated the clinical characteristics, practice patterns, and long-term prognoses of patients presenting to the ED with very severe acute hypertension.
Methods
Cross-sectional study data were obtained from a single regional emergency medical center, including patients aged ≥ 18 years who were admitted to the ED between January 2016 and December 2019 for very severe acute hypertension, which was defined as systolic blood pressure of > 220 mmHg and/or diastolic blood pressure of > 120 mmHg. The patients were classified into two groups based on the presence or absence of hypertension-mediated organ damage (HMOD).
Results
Among 1,391 patients with very severe acute hypertension in the ED, half of the them (50.2%) had a previous medical history of hypertension, and 547 (39.3%) had acute HMOD. The overall 3-month, 1-year, and 3-year mortality rates were 5.2%, 11.9%, and 17.3%, respectively. In particular, patients with HMOD had a significantly higher mortality rate at each time point than those without HMOD. Among patients with HMOD, acute ischemic stroke was the most common (28.7%). Moreover, intravenous antihypertensive drugs were significantly more prescribed in patients with HMOD than in those without HMOD (79.0% vs. 22.2%, P < 0.001), but there were no differences in oral antihypertensive drugs between the two groups.
Conclusions
Patients with very severe acute hypertension had poor long-term clinical prognoses. Clinicians should be continuously monitoring and providing appropriate treatment and close follow-up for patients with very severe acute hypertension.
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