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Profile and management of hypertensive urgencies and emergencies in the emergency cardiology department of a tertiary hospital: a 12-month registry.
Eur J Prev Cardiol. 2022 02 19; 29(1):194-201.EJ

Abstract

AIMS

Currently there are scarce epidemiological data regarding prevalence, clinical phenotype, and therapy of hypertensive urgencies (HU) and emergencies (HE). The aim of this article was to record the prevalence, clinical characteristics, and management of patients with HU and HE assessed in an emergency department (ED) of a tertiary hospital.

METHODS AND RESULTS

The population consisted of patients presenting with HE and HU in the ED (acute increase in systolic blood pressure (BP) ≥ 180 mmHg and/or diastolic BP ≥120 mmHg with and without acute target organ damage, respectively). Of the 38 589 patients assessed in the ED during a 12-month period, 353 (0.91%) had HU and HE. There were 256 (72.5%) cases presented as HU and 97 (27.5%) as HE. Primary causes for both HU and HE were stress/anxiety (44.9%), increased salt intake (33.9%), and non-adherence to medication (16.2%). Patients with HU reported mainly dizziness/headache (46.8%) and chest pain (27.4%), whereas those with HE presented dyspnoea (67%), chest pain (30.2%), dizziness/headache (10.3%), and neurological disorders (8.2%). In HE, the underlying associated conditions were pulmonary oedema (58%), acute coronary syndrome (22.6%), and neurological disorders/stroke (7.2%). All HE cases were hospitalized and received intensive healthcare, including dialysis.

CONCLUSION

This 1-year single-centre registry demonstrates a reasonable prevalence of HU and HE contributing to the high volume of visits to the ED. Stress, increased salt intake and non-adherence were main triggers of HE and HU. Dizziness and headache were the prevalent symptoms of HU patients while heart failure was the most common underlying disease in patients with HE.

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Publisher Full Text (DOI)

Authors+Show Affiliations

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

Konstantinidis D

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

Nihoyannopoulos P

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

Second Neurologic Department (Clinic), Medical School, University of Athens, Attikon Hospital, Athens, Greece.

Department of Cardiology, Helena Venizelou Hospital, Athens, Greece.

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

First Cardiologic Department (Clinic), Medical School, University of Athens, Hippokration Hospital, 114 Vasilissis Sofias Avenue, 11527 Athens, Greece.

MeSH

Antihypertensive AgentsCardiologyEmergenciesHumansHypertensionRegistriesTertiary Care Centers

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34718521

Citation

Fragoulis, Christos, et al. "Profile and Management of Hypertensive Urgencies and Emergencies in the Emergency Cardiology Department of a Tertiary Hospital: a 12-month Registry." European Journal of Preventive Cardiology, vol. 29, no. 1, 2022, pp. 194-201.

Fragoulis C, Dimitriadis K, Siafi E, et al. Profile and management of hypertensive urgencies and emergencies in the emergency cardiology department of a tertiary hospital: a 12-month registry. Eur J Prev Cardiol. 2022;29(1):194-201.

Fragoulis, C., Dimitriadis, K., Siafi, E., Iliakis, P., Kasiakogias, A., Kalos, T., Leontsinis, I., Andrikou, I., Konstantinidis, D., Nihoyannopoulos, P., Tsivgoulis, G., Thomopoulos, C., Tousoulis, D., Muiesan, M. L., & Tsioufis, K. P. (2022). Profile and management of hypertensive urgencies and emergencies in the emergency cardiology department of a tertiary hospital: a 12-month registry. European Journal of Preventive Cardiology, 29(1), 194-201. https://doi.org/10.1093/eurjpc/zwab159

Fragoulis C, et al. Profile and Management of Hypertensive Urgencies and Emergencies in the Emergency Cardiology Department of a Tertiary Hospital: a 12-month Registry. Eur J Prev Cardiol. 2022 02 19;29(1):194-201. PubMed PMID: 34718521.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Profile and management of hypertensive urgencies and emergencies in the emergency cardiology department of a tertiary hospital: a 12-month registry. AU - Fragoulis,Christos, AU - Dimitriadis,Kyriakos, AU - Siafi,Eirini, AU - Iliakis,Panagiotis, AU - Kasiakogias,Alexandros, AU - Kalos,Theodoros, AU - Leontsinis,Ioannis, AU - Andrikou,Ioannis, AU - Konstantinidis,Dimitrios, AU - Nihoyannopoulos,Petros, AU - Tsivgoulis,Georgios, AU - Thomopoulos,Costas, AU - Tousoulis,Dimitrios, AU - Muiesan,Maria L, AU - Tsioufis,Konstantinos P, PY - 2021/06/22/received PY - 2021/08/12/revised PY - 2021/09/08/accepted PY - 2021/11/1/pubmed PY - 2022/4/6/medline PY - 2021/10/31/entrez KW - Hospitalizations KW - Hypertensive emergencies KW - Hypertensive urgencies KW - Pharmacological treatments SP - 194 EP - 201 JF - European journal of preventive cardiology JO - Eur J Prev Cardiol VL - 29 IS - 1 N2 - AIMS: Currently there are scarce epidemiological data regarding prevalence, clinical phenotype, and therapy of hypertensive urgencies (HU) and emergencies (HE). The aim of this article was to record the prevalence, clinical characteristics, and management of patients with HU and HE assessed in an emergency department (ED) of a tertiary hospital. METHODS AND RESULTS: The population consisted of patients presenting with HE and HU in the ED (acute increase in systolic blood pressure (BP) ≥ 180 mmHg and/or diastolic BP ≥120 mmHg with and without acute target organ damage, respectively). Of the 38 589 patients assessed in the ED during a 12-month period, 353 (0.91%) had HU and HE. There were 256 (72.5%) cases presented as HU and 97 (27.5%) as HE. Primary causes for both HU and HE were stress/anxiety (44.9%), increased salt intake (33.9%), and non-adherence to medication (16.2%). Patients with HU reported mainly dizziness/headache (46.8%) and chest pain (27.4%), whereas those with HE presented dyspnoea (67%), chest pain (30.2%), dizziness/headache (10.3%), and neurological disorders (8.2%). In HE, the underlying associated conditions were pulmonary oedema (58%), acute coronary syndrome (22.6%), and neurological disorders/stroke (7.2%). All HE cases were hospitalized and received intensive healthcare, including dialysis. CONCLUSION: This 1-year single-centre registry demonstrates a reasonable prevalence of HU and HE contributing to the high volume of visits to the ED. Stress, increased salt intake and non-adherence were main triggers of HE and HU. Dizziness and headache were the prevalent symptoms of HU patients while heart failure was the most common underlying disease in patients with HE. SN - 2047-4881 UR - https://www.unboundmedicine.com/medline/citation/34718521/Profile_and_management_of_hypertensive_urgencies_and_emergencies_in_the_emergency_cardiology_department_of_a_tertiary_hospital:_a_12_month_registry_ DB - PRIME DP - Unbound Medicine ER -