Abstract 18025: Hypertensive Emergencies and Urgencies: Prevalence and Clinical Characteristics of Patients Admitted to an Emergency Department.
Background: few data are avaliable on the prevalence of hypertensive emergencies and urgencies and on clinical characteristics of patients admitted to Emergency Departments (ED). The only available Italian data have been published in 1996. Aim of our study was to provide data on the prevalence of hypertensive emergencies and urgencies in an ED in Northern Italy, over a period of 12 months.
Methods: between January and December 2008, medical records of patients aged ≥18 yrs, admitted to the ED of the Spedali Civili di Brescia with blood pressure values ≥180 mmHg (SBP) and/or ≥120 mmHg (DBP) were collected and analysed.
Results: out of 77.154 patients admitted to the ED, in 2.2% BP was ≥180 mmHg (SBP) and/or ≥120 mmHg (DBP); 95% of medical records of these patients were analysed (1636 pts, 44% males, mean age 70±14 yrs, range 18–102). According to the clinical presentation and the presence of organ damage 331 pts were classified as “hypertensive emergency” (BP 193±15/102±15 mmHg), 110 as “hypertensive urgency” (BP 199±16/104±17 mmHg), 903 as “pseudo hypertensive urgency” (BP 188±11/94±12 mmHg), 259 had “uncontrolled hypertension” (BP 192±15/97±14 mmHg) and 33 had a “first diagnosis of hypertension” (BP 193±18/103±14 mmHg). The most frequent symptoms or signs were: chest pain (20%), dyspnoea (18%), neurological changes (17%), headache (11%), arrhythmias (6%), changes in consciousness (3%). Among hypertensive emergencies the prevalence of different organ damage was, respectively: 32% ischemic stroke, 25% acute coronary syndromes, 25% acute pulmonary oedema, 10% arrhythmias, 7% hemorrhagic stroke, 1% aortic dissection.
Conclusions: admission to the ED for hypertensive emergencies and urgencies is still high. Our results underline the need for an accurate differentiation of various clinical conditions for an optimal use of medical resources.
- © 2010 by American Heart Association, Inc.