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

E V Kryukov, N P Potekhin, A N Fursov

    Klinicheskaia Meditsina
    |May 14, 2016
    PubMed

    Insights

    Hypertensive crisis (HC) in patients with arterial hypertension (AH) decreased from 30% in the 1980s to 16% by 2012. This shift reflects more mild cases, with complicated crises potentially underreported in statistics.

    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.

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