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Hypertensive crisis. Clinical presentation, comorbidities, and target organ involvement
Rashed Al-Bannay1, Aysha A Husain
1Cardiology Unit, Internal Medicine Department, Salmaniya Medical Complex, PO Box 12, Manama, Kingdom of Bahrain. abdullarashed@yahoo.com
Insights
Hypertensive crisis, particularly hypertensive emergency, is linked to diabetes mellitus and symptoms like shortness of breath and neurological deficits. Most patients had prior hypertension, highlighting the need for better management.
Area of Science:
- Cardiology
- Internal Medicine
- Public Health
Background:
- Hypertensive crisis is a serious medical condition requiring prompt evaluation.
- Understanding clinical presentation and comorbidities is crucial for effective management.
- Previous studies have not fully characterized hypertensive crisis in the Bahraini population.
Purpose of the Study:
- To assess the clinical features and associated comorbidities of hypertensive crisis.
- To differentiate between hypertensive urgency and hypertensive emergency in the study cohort.
- To identify risk factors and predictors of hypertensive crisis.
Main Methods:
- A cohort-based study was conducted from January to April 2009.
- Included 154 patients admitted with severe hypertension (systolic >179 mm Hg, diastolic >119 mm Hg).
- Data analysis focused on clinical presentation, comorbidities, and outcomes.
Main Results:
- 64.3% experienced hypertensive urgency, while 35.7% had hypertensive emergency.
- The 45-65 age group constituted 56% of patients; men were more affected than women (100:54).
- Shortness of breath and neurological deficits were associated with hypertensive emergency; headache and blurred vision with urgency. Diabetes mellitus was an independent risk factor.
Conclusions:
- The majority of patients with hypertensive crisis had pre-existing hypertension.
- Diabetes mellitus is a significant predictor of hypertensive crisis.
- Dyspnea and neurological deficits strongly correlate with hypertensive emergencies, underscoring their severity.
Objective:
To evaluate the clinical presentation and comorbidities of hypertensive crisis in our own population.
Methods:
In this cohort based study, we investigate the clinical presentation and comorbidities of hypertensive crisis by evaluating the data collected between January and April 2009. We included 154 patients admitted with systolic and diastolic blood pressure of >179 mm Hg and >119 mm Hg (based on the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure criteria) in the Department of Internal Medicine, Salmaniya Medical Complex, Kingdom of Bahrain.
Results:
In the study population, 64.3% had hypertensive urgency (blood pressure elevation without end organ damage) and 35.7% had hypertensive emergency (blood pressure elevation with end organ damage). The mean age group was 45-65 years (56% of the study population) and more men were affected than women (100:54). Shortness of breath and neurological deficits had a strong statistical association with hypertensive emergency, and headache and blurring of vision had the same tendency toward hypertensive urgency. Diabetes mellitus was an independent risk factor for hypertensive crisis.
Conclusion:
Most of the studied patients were known hypertensive. Diabetes mellitus is powerful predictor for hypertensive crisis. Dyspnea and neurological deficits have significant statistical correlation with hypertensive emergencies.
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