Abstract

Introduction: Hypertensive crisis is common among patients visiting emergency room (ER). Majority of these patients can be treated on an outpatient basis (hypertensive urgency). Other patients have acute end-organ damage and higher morbidity and mortality (hypertensive emergency). However, no study on the prevalence of hypertensive emergency in ER in Thailand was found. We aim to evaluate the prevalence and also potential predictors of hypertensive emergency. Methods: Medical records of patients who have systolic blood pressure > 180 mmHg and/or diastolic blood pressure > 120 mmHg were reviewed. The exclusion criteria include age < 18 years old, near death, a history of recent traumatic event, and a diagnosis of an acute ischemic stroke fast track. The patients were classified into two groups: hypertensive emergency and hypertensive urgency. The prevalence of hypertensive emergency and potential predictors of hypertensive emergency was analyzed. Results: From June 1, 2013 to August 18, 2014, we found 307 patients with hypertensive crisis and 60 patients (19.5%) were hypertensive emergency. Among several potential predictors of hypertensive emergency, these 3 predictors: dyspnea, dizziness and being transferred from outpatient department (OPD) to ER due to hypertensive crisis were significant. Conclusion: Hypertensive emergency is common among patients with hypertensive crisis in ER. Dyspnea is a positive predictor of hypertensive emergency. Negative predictors include dizziness and being transferred from OPD to ER.

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