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[Prevalence of high blood pressure in hospitalized patients. A cross-sectional study]
Martin I Lapidus1, André Falcón1, Carolina Antonietti2
1Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Argentina.
Insights
Elevated blood pressure (EBP) affects 7.6% of hospitalized patients, with many unaware of their condition. This study highlights the association between EBP and cardiovascular events in this population.
Area of Science:
- Cardiology
- Internal Medicine
- Public Health
Background:
- Hypertension (HTN) is a widespread condition with significant public health implications.
- A substantial portion of the population remains unaware of their HTN diagnosis, and many diagnosed patients exhibit poor blood pressure control.
- Standardized methods for diagnosing HTN in hospitalized patients are lacking, necessitating research in this area.
Purpose of the Study:
- To investigate the prevalence of elevated blood pressure (EBP) in hospitalized adult patients.
- To identify the proportion of EBP cases in this setting who are unaware of their hypertension.
- To explore the association between EBP and cardiovascular events during hospitalization.
Main Methods:
- A cross-sectional study was conducted in 2017, including hospitalized adult patients admitted for clinical causes (excluding hypertensive emergencies).
- Elevated blood pressure (EBP) was defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg on two or more occasions across different days, or a one-time indication of antihypertensive medication.
- Data were collected from 2203 patients, analyzing demographic characteristics, medical history, and in-hospital events.
Main Results:
- The prevalence of EBP among hospitalized patients was 7.6% (168 patients), with 12.5% (21 patients) being unaware of their HTN.
- Patients with EBP were older and had higher rates of chronic kidney disease, stroke, and pre-existing HTN compared to those without EBP.
- Elevated blood pressure was associated with increased occurrences of heart failure and stroke during hospitalization.
Conclusions:
- The prevalence of EBP in hospitalized patients is significant, underscoring the need for improved diagnostic strategies in this setting.
- A notable percentage of hospitalized patients with EBP are undiagnosed, highlighting a critical gap in hypertension management.
- Elevated blood pressure in hospitalized patients is linked to adverse cardiovascular outcomes, emphasizing the importance of monitoring and management.
Abstract:
Hypertension (HTN) is a prevalent disease. A 30% of the population is unaware of having HTN and 65% of patients with HTN have a poor control. There is no standardized way to diagnose HTN in the inpatient setting. This is why the focus on this population, both for the diagnosis of HT and for the detection of poor control, is relevant. It was a cross sectional study of hospitalized adult patients (>18 years old) for clinical causes, in 2017. Hypertensive emergencies were excluded. Elevated blood pressure (EBP) was defined as the registry of SBP = 140 and / or DBP = 90 mmHg on two or more occasions, on two different days, measured through a sphygmomanometer, and/or one-time indication of antihypertensive medication. A total of 2203 patients were included. Median age: 73 years (IIQ 25-75%: 56-86). Women: 55% (1203). Median days of hospitalization: 5 (IIQ 25-75% 4-9). A 58% of them were known hypertensive. The prevalence of EBP was 7.6% [168, 95% CI 6.6-8.8], of which 12.5% (21) were unaware of having HTN. Compared to patients without EBP, the mean SBP and DBP were higher, they were older (77 vs. 73 years, p < 0.001), had higher rates of chronic kidney disease (21% vs. 12% p < 0.001), stroke (15% vs. 10% p = 0.035) and HTN (87% vs. 56% p < 0.001). They had more events of heart failure (8% vs. 3%, p <0.001) and stroke (3.6% vs. 1.2%, p = 0.02) during hospitalization. The prevalence of EBP was lower compared to previous studies. We observed an association between cardiovascular events and EBP.
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