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Hypertensive crisis: clinical-epidemiological profile

José Fernando Vilela-Martin1, Renan Oliveira Vaz-de-Melo, Cristina Hiromi Kuniyoshi

  • 1Hypertension Clinic-Hospital de Base, State Medical School of São José do Rio Preto (FAMERP), Sao Paulo, Brazil. vilelamartin@uol.com.br

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|December 17, 2010
PubMed

Insights

Hypertensive crisis (HC) involves acute blood pressure (BP) elevation, manifesting as hypertensive emergency (HE) or urgency (HU). HE patients were older, more sedentary, and less likely to have prior treatment.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Public Health

Background:

  • Hypertensive crisis (HC) is an acute elevation in blood pressure (BP), categorized as hypertensive emergency (HE) with target-organ damage or hypertensive urgency (HU) without it.
  • Both HE and HU typically involve diastolic BP levels of 120 mmHg or higher.
  • Understanding the clinical-epidemiological profile of HC is crucial for effective emergency management.

Purpose of the Study:

  • To characterize the clinical-epidemiological profile of patients experiencing hypertensive crisis (HC) over one year.
  • To differentiate between hypertensive emergency (HE) and hypertensive urgency (HU) based on patient characteristics and outcomes.
  • To conduct a literature review on hypertensive crisis.

Main Methods:

  • A cross-sectional study was conducted over one year (2006) involving 362 patients presenting with HC at a university reference hospital.
  • Patients were classified into HE (231) or HU (131) groups based on the presence of target-organ damage.
  • Clinical-epidemiological data, including demographics, lifestyle factors, and presenting symptoms, were collected and analyzed.

Main Results:

  • Patients with HE were significantly older and more sedentary than those with HU.
  • A lower proportion of HE patients had a history of antihypertensive treatment compared to HU patients.
  • Common symptoms in HE included dyspnea, thoracic pain, and neurological deficit, while HU patients frequently presented with headache, thoracic pain, and dyspnea.

Conclusions:

  • Hypertensive crisis is associated with significant morbidity in emergency settings.
  • Older age, sedentary lifestyle, and lack of prior antihypertensive treatment are associated with hypertensive emergency.
  • Aggressive blood pressure control is essential to prevent severe complications of hypertension.

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