Clinical Presentation of Hypertensive Crises in Emergency Medical Services

Abstract

Objectives:The objective of this study is to evaluate the incidence and clinical presentation of hypertensive crises in the Emergency medical services of the Community Health Centre “Dr. Mustafa Šehović” Tuzla in relation to age, sex, duration and severity of hypertension, as well as the prevalence of accompanying symptoms and clinical manifestations.Methods:The study was conducted between November 2009 and April 2010 and included 180 subjects of both sexes, aged 30-80 with a diagnosis of arterial hypertension. All subjects were divided into two groups: a control group, which consisted of subjects without hypertensive crisis (95 subjects) and an experimental group that consisted of subjects with hypertensive crisis (85 subjects).Results:The study results indicate that female subjects were significantly over- represented compared to men (60% vs. 40 %, p=0.007). The average age of the male subjects was 55.83±11.06 years, while the female subjects’ average age was 59.41±11.97 years. The incidence of hypertensive crisis was 47.22%, with hypertensive urgency significantly more represented than emergency (16.47% vs. 83.53%, p<0.0001). The majority of subjects in the experimental group (28.23%) belonged to the age group of 60-69 years of age: 26.76% urgency and 35.71% emergency. The most common accompanying symptoms in hypertensive subjects were headache (75%), chest pain (48.33%), vertigo (44.44%), shortness of breath (38.88%) and nausea (33.89%). The most common symptoms in subjects with hypertensive crisis were headache (74.11%), chest pain and shortness of breath (62.35%), vertigo (49.41%), and nausea and vomiting (41.17%).Conclusions:Chest pain, shortness of breath, nausea and vomiting were significantly over-represented in subjects with hypertensive crisis (p<0.005). Clinical manifestations of hypertensive emergencies in almost all subjects included acute coronary syndrome, and only one subject had acute pulmonary edema.

Personalised 3D Printed Fast-Dissolving Tablets for Managing Hypertensive Crisis: In-Vitro/In-Vivo Studies

“…The HC can be classified as hypertensive emergency or hypertensive urgency depending on the end-organ involvement, including renal, cardiac and neurologic injury [ 8 , 9 ]. From the estimation, it is reported that approximately 1% of the patients with hypertension develop hypertensive crisis at some point during their life span, however, men are approximately affected two times more frequently than women [ 10 , 11 ].…”

Sublingual vs. Oral Captopril in Hypertensive Crisis

“…Whereas one study showed low absorption of captopril from the sublingual cavity of rabbits, some others found no difference in proportion of BP decrease, plasma rennin activity inhibition, and ACE inhibition (9,12,19). On the other hand, many studies found that sublingual captopril's decrease of blood pressure is better than the oral method (20)(21)(22).…”

“…Hypertensive crisis is characterized by a sudden onset of increased BP and represents more than 25% of all medical urgencies/emergencies, often threatening patients' lives (12). Because different treatment approaches are required, drawing a line between hypertensive emergency and urgency is crucial.…”

Medical and Nonstroke Neurologic Causes of Acute, Continuous Vestibular Symptoms

“…For example, although headaches and dizziness were both found to be common in adults presenting to the emergency department with hypertensive crisis, they were equally common in a control group with uncomplicated hypertension. 103 In children, there may be a stronger association between hypertensive crisis and dizziness. 104 Patients with intracranial hypotension following LP or spontaneous CSF leak may also present with auditory or vestibular symptoms, including acute vertigo.…”