Less successful out-patient systolic blood pressure control was an independent risk factor for hypertensive crisis (OR 1.30 per 10 mmHg increase; 95% CI 1.18-1.42; P<0.001).
Case-Control (n=628)
Does less successful out-patient blood pressure control increase the risk of Emergency Department presentation for hypertensive crisis in patients with hypertension?
Poor out-patient systolic blood pressure control is a significant independent risk factor for presenting to the emergency department with a hypertensive crisis.
Odds Ratio: 1.3 (95% CI 1.18–1.42)
p-value: p=< 0.001
OBJECTIVES: The purpose of this study was to identify independent risk factors for development of hypertensive crisis. METHODS: This was a retrospective, case-controlled study. Cases were 143 patients who presented during a 3-year period to the Emergency Department with the diagnosis of hypertensive crisis, defined as systolic pressure >/=180 mmHg and/or diastolic pressure >/=110 mmHg and symptoms of hypertensive emergency during the Emergency Department presentation. Controls were 485 patients with hypertension, matched to cases on the basis of age, sex and race, who were not admitted to the Emergency Department with an episode of hypertensive crisis during the study period. Co-morbid conditions were identified from computerized health system databases and medical records. Out-patient blood pressures were obtained from medical records from randomly selected out-patient clinic visits. RESULTS: The average blood pressure during Emergency Department presentation in patients with hypertensive crisis was 197 +/- 21/108 +/- 14 mmHg. Less successful out-patient systolic blood pressure control was an independent risk factor for hypertensive crisis odds ratio (OR) 1.30 (1.18-1.42), per 10 mmHg, P < 0.001. Higher out-patient diastolic blood pressures OR 1.21 (0.99-1.43 per 10 mmHg, P = 0.07 and history of heart failure OR 3.48 (0.94-12.94), P = 0.06 trended towards independence as risk factors. CONCLUSION: Less effective blood pressure control, based on out-patient systolic blood pressure measurements, is an independent risk factor for an Emergency Department presentation due to hypertensive crisis.
James E. Tisdale (2004) conducted a case-control in Hypertensive crisis (n=628). Higher out-patient systolic blood pressure vs. Lower out-patient systolic blood pressure was evaluated on Emergency Department presentation due to hypertensive crisis (OR 1.30, 95% CI 1.18-1.42, p=< 0.001). Less successful out-patient systolic blood pressure control was an independent risk factor for hypertensive crisis (OR 1.30 per 10 mmHg increase; 95% CI 1.18-1.42; P<0.001).
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