AETIOLOGICAL AND CLINICAL PROFILE OF HYPERTENSIVE EMERGENCIES IN A TERTIARY CARE HOSPITAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 20
Abstract
BACKGROUND The aetiological and clinical profile of patients with hypertensive emergencies presenting to hospitals in our country is poorly known. Systemic Hypertension is a common medical condition affecting over 1 billion people worldwide. Epidemiological studies indicate that the prevalence of hypertension in adults is around 15% to 22%, depending on the population considered. Although, chronic hypertension was an established risk factor for cardiovascular, cerebrovascular and renal disease, acute elevations in blood pressure can result in acute end organ damage with significant morbidity. The objective of the present study was to list the probable aetiologies, clinical profile, target organ damage spectrum and mortality pattern and its association with variables. MATERIALS AND METHODS The present study was done in patients admitted at Calicut Medical College Hospital, a tertiary referral centre situated in Northern Kerala, over a period of one year. Study design was descriptive study. The study population included patients admitted to emergency department with severely elevated BP with clinical or laboratory evidence of acute organ damage. The clinical and laboratory profile and mortality pattern and its association with variables were evaluated and analysed. RESULTS The mean age was found to be 61 years with a standard deviation of 12 years. Predominant presenting symptoms were acute coronary syndrome followed by intracerebral haemorrhage. Depressed sensorium was present in patients and is significantly associated with mortality. Mean systolic blood pressure was 200 mmHg and mean diastolic blood pressure was 124 mmHg. High systolic and diastolic blood pressure were significantly associated with mortality (p values- 0.00 and 0.00). Serum creatinine was above 2 mg/dL in 40 patients and high creatinine value was statistically related with mortality. End organ damages were acute coronary syndrome followed by intracerebral haemorrhage. The in-hospital mortality was 28%. CONCLUSION Males had a higher chance of developing hypertensive emergencies. The most common target of organ damage was acute coronary syndrome. Higher systolic and diastolic blood pressure were highly associated with mortality. Limitations- The smaller size of the study limits the ability to offer firm conclusions about the relationship between hypertensive emergency and aetiological factors.
Authors and Affiliations
Ashhar C, Mohamed Shaan
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