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Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi

Aysha Almas1, Ayaz Ghouse2, Ahmed Raza Iftikhar2

  • 1Department of Medicine, Stadium Road, Aga Khan University, P.O. Box 3500, Karachi 74800, Pakistan.

International Journal of Chronic Diseases
|October 15, 2015
PubMed

Insights

Hypertensive crisis is common in uncontrolled hypertension patients. Oral calcium channel blockers and IV nitrates were frequently used for management, with varying blood pressure reductions observed.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Public Health

Background:

  • Uncontrolled hypertension poses a significant risk for developing hypertensive crisis.
  • Hypertensive crisis requires prompt management to prevent severe complications.

Purpose of the Study:

  • To determine the prevalence of hypertensive crisis in patients with uncontrolled hypertension.
  • To analyze the management strategies and outcomes of hypertensive crisis.
  • To identify common complications associated with hypertensive crisis.

Main Methods:

  • Cross-sectional study conducted at a tertiary care center in Karachi, Pakistan.
  • Inclusion criteria: Adult inpatients (>18 years) presenting to the ER with known and uncontrolled hypertension.
  • Data collection on patient demographics, management, and complications.

Main Results:

  • Prevalence of uncontrolled hypertension was 28.6%; hypertensive crisis was present in 56.3% of these patients.
  • Most common medications: oral calcium channel blockers (35.4%) and intravenous nitrates (22.7%).
  • Intravenous sodium nitroprusside showed the greatest mean systolic blood pressure drop (80 mm Hg); acute renal failure was the most frequent complication (11.5%).

Conclusions:

  • Hypertensive crisis has a high prevalence among patients with uncontrolled hypertension.
  • Oral calcium channel blockers and intravenous nitrates are the primary medications used in this setting.
  • Effective management is crucial to mitigate complications like acute renal failure.

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