Clin Hypertens.  2022;28(1):23. 10.1186/s40885-022-00208-3.

Clinical characteristics and prognosis of patients with very severe acute hypertension visiting the emergency department

• Kim H
• Kim BS
• Shin J

• KMID: 2532376
• DOI: http://doi.org/10.1186/s40885-022-00208-3

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 present‑ ing 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 hypertensionmediated organ damage (HMOD).
Results
Among 1,391 patients with very severe acute hypertension in the ED, half of the them (50.2%) had a previ‑ ous 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.

Keyword

Very severe acute hypertension; Emergency department; Hypertension-mediated organ damage; Mortality