[HYPERTENSIVE CRISIS: MODERN VIEW OF THE PROBLEM AND OPTIMIZATION OF DIAGNOSTIC AND THERAPEUTIC MODALITIES]

Area of Science:

• Cardiology
• Internal Medicine
• Clinical Research

Background:

• Hypertensive crisis (HC) represented approximately 30% of patients with arterial hypertension (AH) in the 1980s.
• A notable decline in HC incidence to 16% by 2012 was observed.
• An increase in uncomplicated HC cases, from 46% to 62%, was documented.

Purpose of the Study:

• To analyze trends in hypertensive crisis (HC) incidence and outcomes.
• To investigate the reasons for observed changes in HC prevalence and complication rates.
• To clarify the diagnostic and statistical challenges associated with hypertensive crisis.

Main Methods:

• Retrospective analysis of patient data from Burdenko Military Hospital.
• Comparison of HC incidence and complication rates between the 1980s and 2012.
• Review of diagnostic criteria and statistical reporting practices (ICD-10).

Main Results:

• HC incidence among AH patients decreased significantly from the 1980s to 2012.
• The proportion of uncomplicated HC cases rose, while complicated cases appeared to decrease.
• A significant portion of reported elevated blood pressure cases exhibited minimal clinical symptoms.
• Underreporting of HC may occur due to its classification challenges within ICD-10.

Conclusions:

• The observed decrease in complicated hypertensive crises may be influenced by diagnostic and statistical underreporting.
• Effective management strategies for uncomplicated HC and hypertensive disease involve ACE inhibitors and imidazoline receptor agonists.
• Acute, severe HC with target organ damage necessitates intensive care with vasodilators and diuretics.