Background: Hospitalized heart failure (HHF) is a challenging clinical entity in cardiology. Data on HHF patients from the Middle East is scarce. Observational studies may provide an initial insight that could improve disease management and guide the design of future clinical trials. Objective: To evaluate the management, in-hospital mortality, and one-year readmission predictors of HHF patients admitted to the coronary care unit. Setting: Coronary Care Unit, Salmaniya Medical Complex, Bahrain. Design: A Prospective Study. Method: Two hundred forty-five HHF patients were included in the study. Clinical data during hospitalization and upon discharge were recorded from 1 January 2012 to 31 March 2012. Followup was extended for 12-months for readmissions with heart failure (HF). Result: One hundred seventy (69%) were males, and the mean age was 64 years. The main causes of HF decompensation were non-compliance 59 (24%), myocardial ischemia 51 (21%) and hypertensive crisis 39 (16%). Comorbidities included were systemic hypertension, 179 (73%), hyperlipidemia, 166 (68%), and diabetes mellitus, 161 (64%). The mean left ventricular ejection fraction (EF) was 34%. In-hospital mortality rate was 9.4%. Patients who were taking angiotensin receptor blockers (ARB) before admission had reduced in-hospital mortality. Upon discharge, 213 (87%) patients were taking renin-angiotensin system blockers, 170 (69%) were taking beta-blockers, and 66 (27%) were taking mineralocorticoid receptor antagonist (MRA). The rate of readmission with HF was 47% at one year.

Normal heart rate is characteristic of hypertensive urgency. Tachycardia in this setting is an ominous sign and denotes hypertensive complications in particular left ventricular failure. Among diabetics, elevated heart rate is associated with poor glycemic control.

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Objective:To study the long-term cardiovascular and non-cardiovascular outcomes among patients admitted with hypertensive crisis. Methods:A total of 297 (145 diabetics, 152 nondiabetics) patients with hypertensive crisis were followed up for a median of 30 months. Fatal and nonfatal events were tracked. The traced events defined as hypertensive urgency, acute coronary syndrome, left ventricular failure, atrial fibrillation, cerebrovascular or renal failure were consecutively analyzed during the follow-up. Results:Overall, 140 (47%) patients had nonfatal clinical events (115 diabetics and 25 nondiabetics); 37 (12%) patients had fatal clinical events (26 diabetics and 11 nondiabetics).The rate of fatal and nonfatal events was significantly higher in diabetics. The mean time of survival was 25.7 months, with the shortest periods for stroke and left ventricular failure. For nondiabetic participants, the mean time of survival was 31 months. Cox regression analysis identified diabetes mellitus, acute left ventricular failure, stroke and renal impairment as predictors of mortality. Conclusion