Clinical Study of Hypertensive Crisis in Medicine Ward
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 11
Abstract
Introduction: A majority of hypertensive crisis cases are consequent of inadequate medical treatment. Hypertensive crisis is an urgent situation in the emergency department and presents various clinical patterns. The present study aimed to evaluate the risk factors and spectrum of end organ damage in hypertensive crisis. Material and Methods: This study was carried out among 200 patients with SBP ≥180 mm Hg or DBP ≥ 120 mm Hg admitted to medicine ward. On admission detailed history, complete clinical examination, and necessary investigations were done to assess the end organ damage. Among 200 patients of hypertensive crisis (HTN-C), 144 individuals (72%) met the criteria for hypertensive emergency (HTN-E) and 56 (28%) met the criteria for hypertensive urgency (HTN-U). Results: Patients with HTN-E were older (P<0.001), more sedentary (P=0.037), more smoker (p=0.0073) and more non adherent to anti hypertensive medications (p=0.049) than those with HTN-U. Furthermore, fewer HTN-E patients than HTN-U patients had known history of hypertension (P=0.0029). Retinopathy (66%), ischemic stroke (23%), hemorrhagic stroke (16%), acute heart failure (18%) and acute coronary syndrome (16%) were target-organ damage in HTN-E. The prevalence of hypertensive crisis in the patients admitted to the ICU is approximately 1.76%. Conclusion: The early detection of end organ damage and appropriate treatment are key determinants to avoid severe complications of hypertension.
Authors and Affiliations
Shailendra Kumar Manjhvar, Shivaji Thakare, Hariom Gupta, Manoj Indurkar
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