Short-Term Mortality Associated With Hypertensive Emergencies: A Prospective Observational Cohort Study From South...

Area of Science:

• Cardiology
• Nephrology
• Critical Care Medicine

Background:

• Hypertensive emergencies, characterized by severe blood pressure elevation and end-organ damage, affect 1-2% of hypertensive patients.
• These emergencies are a critical complication of hypertension requiring immediate medical attention.

Purpose of the Study:

• To evaluate the short-term outcomes of patients experiencing hypertensive emergencies.
• To identify factors predicting mortality in this patient population.

Main Methods:

• A prospective cohort study involving 66 adult patients with hypertensive emergencies.
• Data collection included sociodemographics, clinical status, blood pressure, end-organ damage, and in-hospital outcomes.
• Four-week follow-up via telephone interviews and logistic regression analysis for mortality predictors.

Main Results:

• The study enrolled 66 patients (66.35% male, mean age 54.57 years), with 83.35% having pre-existing hypertension, many discontinuing medication.
• Common complications included dyspnea (53.03%), pedal edema (43.94%), and acute-on-chronic kidney disease (31.81%).
• Short-term mortality at one month was 36.36%, with post-hospitalization deaths exceeding in-hospital deaths.

Conclusions:

• Hypertensive emergencies are associated with substantial short-term mortality, exceeding one-third within one month.
• Newly diagnosed hypertension and in-hospital hypotension were identified as significant mortality predictors.
• A high proportion of patients discontinued antihypertensive medications prior to admission, contributing to adverse outcomes.