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.

Clinico-epidemiological characteristics and survival outcome of patients with hypertensive crisis at Kassala Hospital, Eastern Sudan

“…The main indings of this study was that the prevalence of hypertensive crisis among patients admitted to the medical emergency room at kassala teaching hospital was .81%, which is comparable to other study conducted by Carrillo et al, who reported a prevalence of HC of 0.6% among patients brought to the clinical emergency department in a Spanish university-af iliated hospital [11]. However it is inconsistent with the studies from Italy, Brazil, Bosnia and Pakistan where estimated prevalence of HC was reported as 3%,16%,47.2%and 56% respectively [1,[12][13][14]. The difference in the prevalence rate of HC between the later studies and our result may be justi ied by inclusion of hypertensive pseudocrisis which may mimic hypertensive urgency, which may alter the inal results of the study.…”

“…In sub-Saharan Africa the prevalence of hypertension was estimated by 30% among general population. In the Eastern Mediterranean Region, the prevalence of hypertension was reported as 26% [1,2]. The prevalence of Hypertension among non-communicable diseases has been accounted for 23.6 % and 39.6% in central and Northern Sudan respectively [3,4].…”

Caracterização E Classificação De Risco Em Urgência E Emergência Hipertensiva

“…Como a elevação crítica da PA nem sempre está associada com sinais e sintomas específicos devido às características assintomáticas da doença, a maioria dos usuários foi considerada com queixas que caracterizam o não se sentir bem, sendo utilizado predominantemente o fluxograma Mal-estar em adultos. Um estudo realizado na Bósnia corroborou estes resultados quando mostrou que não se sabe em que momento da elevação persistente e significativa da PA caracteriza-se uma urgência/emergência hipertensiva, pois em aproximadamente 50% das pessoas diagnosticadas como urgência/emergência hipertensiva a doença progrediu de forma assintomática, dificultando o tratamento (13) .…”

“…Cefaleia, dor no peito e dispneia foram significativamente mais presentes em pacientes com emergência hipertensiva (p < 0,005). As manifestações clínicas da EH foram relativas à síndrome coronariana aguda (92,9%) e edema pulmonar agudo (7,1%) (13) .…”

Dental Care in Hypertense Patients: Systematic Review

“…AH is a relatively common condition, affecting around 22% to 41% of the adult Brazilian population [2]. In addition, it accounts for more than 7 million deaths annually [3] and is considered a risk factor for cardiovascular disease [4].…”