Long-Term Mortality and Role of Troponin Elevation in Hypertensive Emergencies

Introduction: Hypertensive crisis (HC) is recognized consequence of inadequate blood pressure (BP) control. A hypertensive crisis is further divided into hypertensive emergency (HT-E) and hypertensive urgency (HT-U). Method: Using a cross-sectional hospital-based study design, patients who had been diagnosed as having HC between January and October 2017 were consecutively recruited in the study. The criteria proposed by the Seventh Joint National Committee were used for the defi nition of HC. Result: A total of 81 (.81%) patients newly diagnosed as having HC were enrolled in the study. Of these patients, 50 (61.7 %) patients met criteria for HT-E, while 31 (38.3%) patients had HT-U. Renal impairment (16%), stroke (30.8%), acute coronary syndrome (13.6%) and heart failure (22.2%) were predominant complications associated with HT-E. Out of 81 study subjects, 13 (16%) patients died. Although there was no signifi cant difference in residence, history of smoking, Diabetes mellitus and history of alcohol consumption between groups, old age (P=.o22), male gender(.046), history of hypertension(.007), history of non-governmental employee(.003), poor compliance (p=.002) and high case fatality rate (p=.041) were signifi cantly associated with hypertensive emergency (HT-E). Conclusion: This study showed that HT-E has high case fatality rate among patients admitted with hypertensive crisis at kassala teaching Hospital. Therefore early detection of hypertension and appropriate management are the main stay for reducing morbidity and mortality among patients with hypertensive crisis.

show abstract

“…The greater case fatality rate shown in this study was comparable to that reported by many other studies [26][27][28].…”

Section: Discussionsupporting

confidence: 90%

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

Abdallah¹,

Ibrahem²,

Ali³

et al. 2018

J Clin Intensive Care Med

View full text Add to dashboard Cite

show abstract

“…An American retrospective analysis of 567 patients admitted with hypertensive emergencies found that long-term mortality was 12% per year after 3.1 years of follow-up. 9 Our objective was therefore to describe and compare short-term (hospital) and long-term (12 months) mortality between patients with hypertensive emergencies and urgencies.…”

Section: A Recent Report From the Nationwide Emergency Departmentmentioning

confidence: 99%

Hospital and out‐of‐hospital mortality in 670 hypertensive emergencies and urgencies

Guiga

Decroux

Michelet

et al. 2017

J of Clinical Hypertension

View full text Add to dashboard Cite

Long-term mortality in patients with acute severe hypertension is unclear. The authors aimed to compare short-term (hospital) and long-term (12 months) mortality in these patients. A total of 670 adults presenting for acute severe hypertension between January 1, 2015, and December 31, 2015, were included. A total of 57.5% were hypertensive emergencies and 66.1% were hospitalized: 98% and 23.2% of those with hypertensive emergencies and urgencies, respectively (P = .001). Hospital mortality was 7.9% and was significantly higher for hypertensive emergencies (12.5% vs 1.8%, P = .001). At 12 months, 106 patients died (29.4%), mainly from hypertensive emergencies (38.9% vs 8.9%, P = .001). Median survival was 14 days for neurovascular emergencies and 50 days for cardiovascular emergencies. Patients with hypertensive emergencies or urgencies had bad long-term prognosis. Short-term mortality is mainly caused by neurovascular emergencies, but cardiovascular emergencies are severe, with high mortality at 12 months. These results justify better follow-up and treatment for these patients.

show abstract

“…Their physiological status is worse, and there are more accompanying diseases than in ordinary patients. Previous studies have found that every 20/10 mm Hg increase in BP contributed to an increased risk of cardiovascular events in seniors with BP >115/75 mm Hg ( 6 , 7 ). Roughly consistent with the findings of these previous studies, our results demonstrated that higher BP was associated with an increased risk of mortality in AF patients with SBP > 110, MBP > 70, or DBP > 55 mm Hg.…”

Section: Discussionmentioning

confidence: 99%

“…Blood pressure (BP) also has an important effect on mortality. Every 20/10 mm Hg increase in BP doubles cardiovascular risk in seniors with BP >115/75 mm Hg ( 6 , 7 ). Previous studies have confirmed the strong association between BP and cardiovascular events.…”

Section: Introductionmentioning

confidence: 99%

U-Shaped Association Between Blood Pressure and Mortality Risk in ICU Patients With Atrial Fibrillation: The MIMIC-III Database

Shao

Hu²

2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundExisting evidence on the association between blood pressure (BP) and mortality risk in intensive care unit (ICU) patients with atrial fibrillation (AF) is scarce.AimThis study aimed to assess the associations between blood pressure (BP) and risks of in-hospital and all-cause mortality in ICU patients with AF.MethodsA total of 2,345 records of patients with AF whose BP was monitored after admission to the ICU were obtained from the MIMIC-III database. Incidences were calculated for endpoints (hospital mortality, 7-day mortality, 30-day mortality, and 1-year mortality). We performed smooth curve and logistic regression analyses to evaluate the association between BP and the risk of each endpoint.ResultsSmooth curve regression showed that systolic blood pressure (SBP), mean arterial pressure (MBP), and diastolic blood pressure (DBP) followed U-shaped curves with respect to endpoints (hospital mortality, 7-day mortality, 30-day mortality, and 1-year mortality). The incidence of these endpoints was lowest at 110/70/55 mm Hg. There was an increased risk of 1-year mortality observed with BP > 110/70/55 mm Hg (SBP, odds ratio [OR] = 1.008, 95% CI 1.001–1.015, p = 0.0022; MBP, OR = 1.010, 95% CI 1.005–1.016, p < 0.001) after adjusting for age, sex, and medical history. In contrast, an inverse association between BP and the risk of 1-year mortality was observed with BP ≤ 110/70/55 mm Hg (SBP, OR = 0.981, 95% CI 0.974–0.988, p < 0.001; MBP OR = 0.959, 95% CI 0.939–0.979, p < 0.001; and DBP, OR = 0.970, 95% CI 0.957–0.983, p < 0.001).ConclusionsWe observed a U-shaped association between BP and in-hospital/all-cause mortality in ICU patients with AF. However, the underlying causes need to be investigated.

show abstract

Long-Term Mortality and Role of Troponin Elevation in Hypertensive Emergencies

Cited by 6 publications

References 3 publications

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

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

Hospital and out‐of‐hospital mortality in 670 hypertensive emergencies and urgencies

U-Shaped Association Between Blood Pressure and Mortality Risk in ICU Patients With Atrial Fibrillation: The MIMIC-III Database

Contact Info

Product

Resources

About