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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
BELTRAN-CASTRO, Marvin S.; TOCORA-RODRIGUEZ, Juan C. and PARGA-ESCOBAR, Néstor J.. Clinical characterization and identification of factors associated with hypertensive crises in the emergency department. Rev. Colomb. Cardiol. [online]. 2023, vol.30, n.2, pp.108-119. Epub May 01, 2023. ISSN 0120-5633. https://doi.org/10.24875/rccar.22000030.
Introduction:
Arterial hypertension (AHT) can debut with a hypertensive crisis (HC), whose prevalence is 1-2%. They are classified as: urgency (HU), emergency (HE) and pseudocrisis (HP).
Objective:
To determine the clinical characterization and identification of factors associated with HC in the emergency service.
Materials and method:
Analytical cross-sectional study based on records of patients ≥18 years who attended the emergency room between 2020 and 2021 with blood pressure (BP) ≥180/120 mmHg and a confirmed diagnosis of HC. Prevalences were estimated, odds ratio and logistic regression models were calculated, with confidence levels of 95%.
Results:
The prevalence of HC was 1.7%. 59.4% were women, aged 66.34 ± 13.8 years, 88.7% had a history of hypertension. The most frequent chronic treatment was angiotensin II receptor blockers (ARB) (52.9%). The most common HC was HE (54.6%). BP levels were higher in the HE group (p < 0.001). Headache was the most frequent symptom (30.0%). Chronic use of angiotesin-converting enzyme (ACE) inhibitors was associated with a lower probability of presenting with HE (68%). Chronic kidney disease was associated with an increased probability of HU (OR = 2.77; CI 95% = 1.31-5.87), coronary heart disease and cerebrovascular disease with an increased probability of HE (OR = 3.11; CI 95% = 1.31-5.87). CI 95 = 1.15-8.45 and OR = 4.4; CI 95% = 1.69-11.58). The most used therapy for HU and HP was losartan (47.56 and 43.14%), for HE labetalol (48.75%).
Conclusions:
Knowing the frequency and association of HC allows to improve the medical assessment, the use of tests, their treatment and prognosis.
Keywords : Hypertension; Malignant hypertension; Emergencies; Antihypertensive agents; Prevalence.