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Characterization and history of arterial hypertension leading to inpatient treatment
Carsten P Bramlage1,2, Mina Nasiri-Sarvi3, Joan Minguet4
1Institute for Pharmacology and Preventive Medicine (IPPMED), Bahnhofstr. 20, 49661, Cloppenburg, Germany. carsten.bramlage@ippmed.de.
Insights
Most hypertensive patients hospitalized due to symptoms, not just high blood pressure (BP). Secondary hypertension and BP-boosting drugs were common in inpatients.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- Arterial hypertension is a leading global cause of mortality.
- While often managed outpatient, some patients require hospitalization.
- Factors influencing inpatient treatment for hypertension are not well understood.
Purpose of the Study:
- To identify patient characteristics associated with inpatient treatment for arterial hypertension.
Main Methods:
- Retrospective, mono-centric study of 103 hypertensive inpatients.
- Data collected included epidemiological information, symptoms, blood pressure (BP), antihypertensive therapy, and comorbidities.
- Focus on patients treated in the Department of Nephrology and Rheumatology.
Main Results:
- 69% of hospital admissions were due to hypertension-related symptoms (e.g., shortness of breath, dizziness, headache).
- 53% of inpatients had elevated BP (>140/90 mmHg) on admission; 47% had normal BP.
- 34% were therapy-refractory; 60% had secondary hypertension; 32% received hypertension-inducing drugs.
Conclusions:
- Clinical symptoms, not solely elevated BP values, are the primary drivers for hypertensive patient hospitalization.
- A significant proportion of inpatients have secondary hypertension or are on medications that elevate BP.
Background And Aims:
Arterial hypertension is a major cause of death worldwide. For the most part, treatment for hypertension can be performed on an outpatient basis. However, some patients also require inpatient treatment, and the contributing factors for this remain unknown. Therefore, the primary objective of the present study was to determine which patient characteristics are associated with inpatient treatment for arterial hypertension.
Methods:
Here, we conducted a mono-centric study of 103 hypertensive subjects, who were treated as inpatients in the Department of Nephrology and rheumatology of the university medical faculty of Göttingen. Therapies were not altered, and data collection was performed retrospectively. In addition to epidemiological information, the following data were recorded: patient symptoms, blood pressure (BP), anti-hypertensive therapy, and concomitant diseases (e.g., renal and cardiovascular conditions).
Results:
Approximately half (53 %) of all subjects treated on an inpatient basis displayed elevated BP (>140/90 mmHg), while the remaining 47 % of patients showed normotensive readings (<140/90 mmHg) following admission. Moreover, 34 % of patients could be classified as therapy refractory. The main reasons for hospital admission were hypertension-related symptoms, including shortness of breath, dizziness, and headache (69 %). These patients were multi-morbid, with approximately 60 % displaying a secondary form of hypertension. Indeed, over half of the subjects showed renoparenchymatous forms of hypertension, and a large percentage of patients received hypertension-inducing drugs (32 %). Moreover, a high proportion of inpatients were treated with reserve antihypertensives, with the most commonly used drug being Moxonidin.
Conclusion:
The majority of hypertensive patients were hospitalized due to their clinical symptoms and not as a result of BP values alone. The high proportion of patients with secondary forms of hypertension or treated with BP-boosting medications was striking.
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