What is the clinical evidence from this study?

Study design: Cohort. Population: Hypertensive emergencies and urgencies (n=252). Intervention: Hypertensive emergencies (HE) vs. Hypertensive urgencies (HU). Primary outcome: Composite endpoint of cardiovascular events and new ED admissions.

February 28, 2026

“Short-term prognosis of hypertensive emergencies and urgencies: second preliminary report of the ongoing Italian multicenter ERIDANO study”

Key Result

In patients with hypertensive emergencies or urgencies, the composite of cardiovascular events and new ED admissions occurred in 12% at 3 months; female sex and PWV were linked to worse outcomes.

Key Points

This study aims to evaluate the short-term prognosis of hypertensive emergencies and urgencies, focusing on organ damage and outcomes.
Prospective multicenter study enrolling 252 patients with symptomatic BP ≥180/110 mmHg in the emergency department.
Assessment of subclinical hypertension-mediated organ damage within 72 hours and follow-up at 3 months after ED admission.
Clinical evaluations measured blood pressure control and adverse outcomes including cardiovascular events.
90% of hypertensive emergency patients had subclinical hypertension-mediated organ damage vs. 65% in urgencies.
At 3 months, 29% of initially uncontrolled patients achieved blood pressure control with <140/90 mmHg.
12% of patients experienced composite endpoints, including cardiovascular events, primarily influenced by female sex and increased pulse wave velocity.

Study Design

Type

Cohort (n=252)

Multicenter

Yes

Structured PICO

Population

252 patients (21 hypertensive emergencies, 231 hypertensive urgencies) with symptomatic blood pressure ≥ 180/110 mmHg admitted to the emergency department, mean age 61 ± 14 years, 52% males, in Italy.

Outcome

Composite endpoint of cardiovascular events and new emergency department admissions at 3 monthscomposite

In patients presenting with hypertensive emergencies and urgencies, subclinical organ damage is highly prevalent, and female sex along with increased pulse wave velocity are associated with worse short-term clinical outcomes.

Abstract

Hypertensive emergencies (HE) and urgencies (HU) are significant challenges for emergency physicians and hypertension specialists. The Eridano study is a prospective multicenter investigation assessing acute blood pressure (BP) disorders, subclinical hypertension-mediated organ damage (HMOD), and short- and long-term prognosis, including cardiovascular complications, new ED admissions, and BP control. Patients with symptomatic BP ≥ 180/110 mmHg admitted to the ED were enrolled and managed by ED personnel. Clinical evaluation and subclinical-HMOD assessment were performed at a Hypertension Centre within 72 h, followed by a 3-month follow-up. A total of 252 patients (21 HE, 231 HU) were included (mean age 61 ± 14 years, 52% males). Subclinical-HMOD was more common in HE (90% vs. 65%), including cardiac (76% vs. 43%), renal (40% vs. 11%), and cerebral (73% vs. 12%) damage. Vascular-HMOD was similar between the groups (54%), with increased pulse wave velocity (PWV) in 44% of patients. BP control (<140/90 mmHg) was achieved in 36% at 72 h. At 3 months, both groups showed lower systolic BP, and 29% of patients with uncontrolled BP at baseline achieved control. Female sex, lower ascending aorta diameter, and lower E/e' ratio were associated with BP control. The composite endpoint (cardiovascular events and new ED admissions) occurred in 12% of patients at 3 months (4% major events, 7% new HU). Multivariate analysis showed female sex and PWV were associated with adverse outcomes. Two-thirds of patients had subclinical HMOD, primarily affecting large arteries and the heart. Female sex and PWV were associated with worse outcomes.

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