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. 2020 Jan;38(1):52-58.
doi: 10.1097/HJH.0000000000002213.

Hypertensive emergencies and urgencies: a single-centre experience in Northern Italy 2008-2015

Massimo Salvetti  1 , Anna Paini, Efrem Colonetti, Luca Tarozzi, Fabio Bertacchini, Carlo Aggiusti, Deborah Stassaldi, Claudia Agabiti Rosei, Enrico Agabiti Rosei, Maria Lorenza Muiesan
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Hypertensive emergencies and urgencies: a single-centre experience in Northern Italy 2008-2015

Massimo Salvetti et al. J Hypertens. 2020 Jan.

Abstract

Background: An increasing attention is given to emergency departments (EDs) admissions for an acute and severe rise in blood pressure (BP). Data on epidemiology and treatment of hypertensive emergencies and urgencies admitted to ED are still limited. The aim of our study was to evaluate the prevalence, clinical presentation and treatment of patients admitted for hypertensive emergencies or hypertensive urgencies.

Methods: Medical records of consecutive patients aged at least 18 years, admitted to the ED of the Spedali Civili in Brescia in 2008 and in 2015 and presenting with SBP at least 180 mmHg and/or DBP at least 120 mmHg were prospectively collected and analysed.

Results: The prevalence of patients admitted with acute BP rise was 2.0% (n = 1551, age 70 ± 14 years) in 2008 and 1.75% (n = 1214, age 69.7 ± 15 years) in 2015. According to the clinical presentation and the presence of acute organ damage, patients were defined hypertensive emergencies (20.4 and 15.4%, respectively, in 2008 and 2015) or as hypertensive urgencies (79.6 and 84.5%, respectively, in 2008 and 2015). SBP and DBP values were higher in patients with emergencies than in those with urgencies (BP 193 ± 15/102 ± 15 vs. 189 ± 13/96 ± 13 mmHg in 2008 and 192 ± 17/98 ± 15 vs. 189 ± 12/94 ± 15 mmHg in 2015, P < 0.001 for both).Among hypertensive emergencies, the different forms of organ damage were 25% acute coronary syndromes and 1% aortic dissection in both periods, 34 and 38% acute heart failure, 40 and 37% stroke.

Conclusion: Admission to the ED for hypertensive emergencies and hypertensive urgencies is still high. Diagnosis and treatment are still not appropriate and require the rapid application of recently published guidelines.

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References

    1. Whelton PK, Carey RM, Aronow WS, Ovbiagele B, Casey DE, Smith SC, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association T. Circulation 2018; 138:e426–e483.
    1. Perez MI, Musini VM. Pharmacological interventions for hypertensive emergencies: a Cochrane systematic review. J Hum Hypertens 2008; 22:596–607.
    1. van den Born BH, Lip GYH, Brguljan-hitij J, Cremer A, Segura J, Morales E, et al. Position paper ESC Council on hypertension position document on the management of hypertensive emergencies. Eur Heart J Cardiovasc Pharmacother 2019; 5:37–46.
    1. Janke AT, Mcnaughton CD, Brody AM, Welch RD, Levy PD. Trends in the incidence of hypertensive emergencies in US Emergency Departments from 2006 to 2013. J Am Heart Assoc 2016; 1–8.
    1. Lip GY, Beevers M, Beevers G. The failure of malignant hypertension to decline: a survey of 24 years’ experience in a multiracial population in England. J Hypertens 1994; 12:1297–1305.