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Clinical Characteristics and Predictors of All-Cause Mortality in Patients with Hypertensive Urgency at an Emergency Department

Hypertensive urgency is characterized by an acute increase in blood pressure without acute target organ damage, which is considered to be managed with close outpatient follow-up. However, limited data are available on the prognosis of these cases in emergency departments. We investigated the charact...

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Autores principales: Shin, Jeong-Hun, Kim, Byung Sik, Lyu, Minhyung, Kim, Hyun-Jin, Lee, Jun Hyeok, Park, Jin-kyu, Lim, Young-Hyo, Shin, Jinho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509826/
https://www.ncbi.nlm.nih.gov/pubmed/34640330
http://dx.doi.org/10.3390/jcm10194314
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author Shin, Jeong-Hun
Kim, Byung Sik
Lyu, Minhyung
Kim, Hyun-Jin
Lee, Jun Hyeok
Park, Jin-kyu
Lim, Young-Hyo
Shin, Jinho
author_facet Shin, Jeong-Hun
Kim, Byung Sik
Lyu, Minhyung
Kim, Hyun-Jin
Lee, Jun Hyeok
Park, Jin-kyu
Lim, Young-Hyo
Shin, Jinho
author_sort Shin, Jeong-Hun
collection PubMed
description Hypertensive urgency is characterized by an acute increase in blood pressure without acute target organ damage, which is considered to be managed with close outpatient follow-up. However, limited data are available on the prognosis of these cases in emergency departments. We investigated the characteristics and predictors of all-cause mortality in Korean emergency patients with hypertensive urgency. This cross-sectional study included patients aged ≥18 years who visited an emergency tertiary referral center between January 2016 and December 2019 for hypertensive urgency, which was defined as a systolic blood pressure of ≥180 mmHg and a diastolic blood pressure of ≥110 mmHg, or both, without acute target organ damage. The 1 and 3 year all-cause mortality rates were 6.8% and 12.1%, respectively. The incidence of emergency department revisits and readmission after 3 months and 1 year was significantly higher in non-survivors than in survivors. In a multivariate analysis, age ≥ 60 years (hazard ratio (HR), 16.66; 95% CI, 6.20–44.80; p < 0.001), male sex (HR, 1.54; 95% CI, 1.22–1.94; p < 0.001), history of chronic kidney disease (HR, 2.18; 95% CI, 1.53–3.09; p < 0.001), and proteinuria (HR, 1.94; 95% CI, 1.53–2.48; p < 0.001) were independent predictors of 3 year all-cause mortality. The all-cause mortality rate of hypertensive urgency remains high despite the increased utilization of antihypertensive medications. Old age, male sex, history of chronic kidney disease, and proteinuria were poor prognostic factors for all-cause mortality in patients with hypertensive urgency.
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spelling pubmed-85098262021-10-13 Clinical Characteristics and Predictors of All-Cause Mortality in Patients with Hypertensive Urgency at an Emergency Department Shin, Jeong-Hun Kim, Byung Sik Lyu, Minhyung Kim, Hyun-Jin Lee, Jun Hyeok Park, Jin-kyu Lim, Young-Hyo Shin, Jinho J Clin Med Article Hypertensive urgency is characterized by an acute increase in blood pressure without acute target organ damage, which is considered to be managed with close outpatient follow-up. However, limited data are available on the prognosis of these cases in emergency departments. We investigated the characteristics and predictors of all-cause mortality in Korean emergency patients with hypertensive urgency. This cross-sectional study included patients aged ≥18 years who visited an emergency tertiary referral center between January 2016 and December 2019 for hypertensive urgency, which was defined as a systolic blood pressure of ≥180 mmHg and a diastolic blood pressure of ≥110 mmHg, or both, without acute target organ damage. The 1 and 3 year all-cause mortality rates were 6.8% and 12.1%, respectively. The incidence of emergency department revisits and readmission after 3 months and 1 year was significantly higher in non-survivors than in survivors. In a multivariate analysis, age ≥ 60 years (hazard ratio (HR), 16.66; 95% CI, 6.20–44.80; p < 0.001), male sex (HR, 1.54; 95% CI, 1.22–1.94; p < 0.001), history of chronic kidney disease (HR, 2.18; 95% CI, 1.53–3.09; p < 0.001), and proteinuria (HR, 1.94; 95% CI, 1.53–2.48; p < 0.001) were independent predictors of 3 year all-cause mortality. The all-cause mortality rate of hypertensive urgency remains high despite the increased utilization of antihypertensive medications. Old age, male sex, history of chronic kidney disease, and proteinuria were poor prognostic factors for all-cause mortality in patients with hypertensive urgency. MDPI 2021-09-22 /pmc/articles/PMC8509826/ /pubmed/34640330 http://dx.doi.org/10.3390/jcm10194314 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shin, Jeong-Hun
Kim, Byung Sik
Lyu, Minhyung
Kim, Hyun-Jin
Lee, Jun Hyeok
Park, Jin-kyu
Lim, Young-Hyo
Shin, Jinho
Clinical Characteristics and Predictors of All-Cause Mortality in Patients with Hypertensive Urgency at an Emergency Department
title Clinical Characteristics and Predictors of All-Cause Mortality in Patients with Hypertensive Urgency at an Emergency Department
title_full Clinical Characteristics and Predictors of All-Cause Mortality in Patients with Hypertensive Urgency at an Emergency Department
title_fullStr Clinical Characteristics and Predictors of All-Cause Mortality in Patients with Hypertensive Urgency at an Emergency Department
title_full_unstemmed Clinical Characteristics and Predictors of All-Cause Mortality in Patients with Hypertensive Urgency at an Emergency Department
title_short Clinical Characteristics and Predictors of All-Cause Mortality in Patients with Hypertensive Urgency at an Emergency Department
title_sort clinical characteristics and predictors of all-cause mortality in patients with hypertensive urgency at an emergency department
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509826/
https://www.ncbi.nlm.nih.gov/pubmed/34640330
http://dx.doi.org/10.3390/jcm10194314
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