Hypertensive crisis: clinical–epidemiological profile

Abstract

Hypertensive crisis (HC) stands out as one type of acute elevation in blood pressure (BP) and can manifest as hypertensive emergency (HE-with target-organ damage (TOD)) or hypertensive urgency (HU-without TOD), usually accompanied by levels of diastolic BP X120 mm Hg. The aim of this study was to characterize the clinical-epidemiological profile of HC over the course of 1 year in a university reference hospital and perform a review of the literature. The study was a cross-sectional study, conducted over a period of 1 year (2006) in 362 patients who presented for treatment at the emergency hospital with HC, as described above. Among all patients examined, 231 individuals met the criteria for HE and 131 met the criteria for HU. Patients with HE were older (Po0.001) and more sedentary (P¼0.026) than those with HU. Furthermore, fewer HE patients than HU patients had previously undergone antihypertensive treatment (P¼0.006). The groups did not differ regarding BP levels, gender, smoking or body mass index. Dyspnea (41.1%), thoracic pain (37.2%) and neurological deficit (27.2%) were common signs/symptoms in those with HE. Meanwhile, in the group with HU, we most frequently found headache (42.0%), thoracic pain (41.2%) and dyspnea (34.3%). Among the forms of HE, we most frequently observed acute lung edema (30.7%), myocardial infarction/unstable angina (25.1%), and ischemic (22.9%) and hemorrhagic (14.8%) stroke. HC is a clinical entity associated with high morbidity in the emergency room. Individuals with HE are older and sedentary and have lower rates of antihypertensive treatment. Adequate control of BP should be pursued as a way to avoid this severe complication of hypertension.

Hyperglycemia in patients with hypertensive crisis: Response to “Hypertensive crisis: Comparison between diabetics and non-diabetics”

“…This condition increases the prevalence of HC, probably being responsible for the large difference in the prevalence found in the literature (0.45 to 27.5%) [2]. Although no significant difference was found between the prevalence of DM or previous antidiabetic treatment in our sample, other study [3] showed a higher prevalence of DM among individuals admitted with HE when compared with those with HU.…”

“…First, we would like to congratulate the authors for their excellent work, and then make some comments regarding the issue addressed and compare their results with those published recently by our group [2]. We found a prevalence of HC that corresponded to 0.45% of all emergencies and 2.0% of clinical emergencies in our service, which is responsible for providing secondary and tertiary care for a population of approximately 1.5 million inhabitants.…”

Hospitalized Infection as a Trigger for Acute Ischemic Stroke

“…1–3 Short term risk factors – or triggers – of acute ischemic stroke include hypertensive crisis 4 , alcohol abuse 5 , and may include acute infection. 5 Herein, we explore the relationship between hospitalization with infection and short-term stroke risk.…”

LEVIS: A hypertension dataset in traditional Chinese medicine

“…25%-35% adults over the world have hypertension. There are over 972 million hypertension patients, of which 60%-70% are over 70 years old [2][3].…”