Patients With Hypertensive Crises Who Are Admitted to a Coronary Care Unit: Clinical Characteristics and Outcomes

González‐Pacheco, Héctor; Victorino, Neisser Morales; Urquiza, Juan Pablo Núñez; Castillo, Alfredo Altamirano; Herrera, Úrsulo Juárez; Arias-Mendoza, Alexandra; Manzur, Francisco Azar; Cruz, J L Briseno De La; Sánchez, Carlos R.

doi:10.1111/jch.12058

Cited by 22 publications

(21 citation statements)

References 22 publications

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“…It affects approximately 1 billion individuals globally [1]. HTN ranked as the leading single factor for Global Burden of Diseases, most notably in Sub-Saharan Africa and South Asia regions where a substantial proportion of the world's population resides.…”

Section: Introductionmentioning

confidence: 99%

Target Organ Damage and the Long Term Effect of Nonadherence to Clinical Practice Guidelines in Patients with Hypertension: A Retrospective Cohort Study

Abegaz

Tefera

Abebe

2017

International Journal of Hypertension

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Background There was limited published data on target organ damage (TOD) and the effect of nonadherence to practice guidelines in Ethiopia. This study determined TOD and the long term effect of nonadherence to clinical guidelines on hypertensive patients. Methods An open level retrospective cohort study has been employed at cardiac clinic of Gondar university hospital for a mean follow-up period of 78 months. Multivariate Cox regression was conducted to test associating factors of TOD. Results Of the total number of 612 patients examined, the overall prevalence of hypertensive TOD was 40.3%. The presence of comorbidities, COR = 1.073 [1.01–1.437], AOR = 1.196 [1.174–1.637], and nonadherence to clinical practice guidelines, COR = 1.537 [1.167–2.024], AOR = 1.636 [1.189–2.251], were found to be predicting factors for TOD. According to Kaplan-Meier analysis patients who were initiated on appropriate medication tended to develop TOD very late: Log Rank [11.975 (p = 0.01)]. Conclusion More than forty percent of patients acquired TOD which is more significant. Presence of comorbidities and nonadherence to practice guidelines were correlated with the incidence of TOD. Appropriate management of hypertension and modification of triggering factors are essential to prevent complications.

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Section: Introductionmentioning

confidence: 99%

Target Organ Damage and the Long Term Effect of Nonadherence to Clinical Practice Guidelines in Patients with Hypertension: A Retrospective Cohort Study

Abegaz

Tefera

Abebe

2017

International Journal of Hypertension

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“…In fact, 25% of patients with hypertensive crisis admitted to the coronary care unit will present with this diagnosis. 10 These patients characteristically have a history of heart failure with preserved ejection fraction. 11 In distinction, neither patient reported here had such a history, and both presented with a decline in their EF from the mid-60% range to less than 50%.…”

Section: Discussionmentioning

confidence: 99%

New-Onset Heart Failure in Association With Severe Hypertension During Trastuzumab Therapy

Herrmann

Haddad

2014

Mayo Clinic Proceedings

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Heart failure is a dreaded complication of trastuzumab therapy in women with breast cancer overexpressing the human epidermal growth factor receptor (HER)-2. Experimental studies have pointed out that the HER-2 signaling pathway is important in the adaptation to high afterload conditions and its inactivation leads to cardiac decompensation. Herein, we report on 2 patients with breast cancer who were receiving trastuzumab monotherapy and required hospital admission for new-onset heart failure. This occurred at a time of unprecedented blood pressure elevations, in one case due to cessation of antihypertensive medications and in the other case due to a scleroderma crisis. Although trastuzumab may not have been the precipitating factor for blood pressure dyscontrol in these patients, severe, uncontrolled hypertension may have been the precipitating factor for trastuzumab-related acute heart failure. These 2 cases add to previous reports recognizing systemic hypertension as a risk factor for the development of trastuzumab cardiotoxicity and translate experimental observations of the significance of the HER-2 signaling pathway to the bedside. Pending further confirmation, the present observations may raise awareness of the need for appropriate monitoring and control of systemic hypertension in patients receiving trastuzumab, or potentially any other HER-2-targeted therapy.

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“…In a recent study with hypertensive crisis patients who were admitted to a coronary care unit, researchers found that the overall mortality was 3.7%. In patients with hypertensive emergency, the mortality was higher (4.6%) compared with patients with hypertensive urgencies (0.8%) (23). Despite the different prognosis between patients with two entities, other researchers tried to find prognostic factors of major adverse cardiac or cerebrovascular events (MACCE) defined as a composite of myocardial infarction, unstable angina, hypertensive crisis, pulmonary edema, stroke, or transient ischemic attack.…”

Section: Prognosismentioning

confidence: 99%

Cardiovascular Hypertensive Crisis: Recent Evidence and Review of the Literature

Varounis

Katsi

Nihoyannopoulos³

et al. 2017

Front. Cardiovasc. Med.

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Despite the high prevalence of hypertension (HTN), only a small proportion of the hypertensive patients will ultimately develop hypertensive crisis. In fact, some patients with hypertensive crisis do not report a history of HTN or previous use of antihypertensive medication. The majority of the patients with hypertensive crisis often report non-specific symptoms, whereas heart-related symptoms (dyspnea, chest pain, arrhythmias, and syncope) are less common. Hypertensive crises can be divided into hypertensive emergencies or hypertensive urgencies according to the presence or absence of acute target organ damage, respectively. This differentiation is an extremely useful classification in clinical practice since a different management is needed, which in turn has a significant effect on the morbidity and mortality of these patients. Therefore, it is very crucial for the physician in the emergency department to identify the hypertensive emergencies and to manage them through blood pressure lowering medications in order to avoid further target organ damage or deterioration. The aim of this narrative review is to summarize the recent evidence in an effort to improve the awareness, recognition, risk stratification, and treatment of hypertensive crisis in patients referred to the emergency department.

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Patients With Hypertensive Crises Who Are Admitted to a Coronary Care Unit: Clinical Characteristics and Outcomes

Cited by 22 publications

References 22 publications

Target Organ Damage and the Long Term Effect of Nonadherence to Clinical Practice Guidelines in Patients with Hypertension: A Retrospective Cohort Study

Target Organ Damage and the Long Term Effect of Nonadherence to Clinical Practice Guidelines in Patients with Hypertension: A Retrospective Cohort Study

New-Onset Heart Failure in Association With Severe Hypertension During Trastuzumab Therapy

Cardiovascular Hypertensive Crisis: Recent Evidence and Review of the Literature

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