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January 1, 2019Einstein (São Paulo)Open Access

Hypertensive crisis: clinical characteristics of patients with hypertensive urgency, emergency and pseudocrisis at a public emergency department

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Key result

Non-chest, non-headache pain linked to ~56-fold higher odds of hypertensive pseudocrisis versus emergency.

  • OR 55.58
  • 95% CI 10.55-292.74
  • P<0.001
  • n=508

Why the study?

Patients with hypertensive crisis can present as urgency, emergency, or pseudocrisis, but clinical characteristics and associated variables are not well defined.

What clinical characteristics are associated with hypertensive urgency, emergency, and pseudocrisis in patients presenting to the emergency department?

Population

508 patients with hypertensive crisis aged 18 years or over at a public emergency department

Comparison

Hypertensive urgency vs hypertensive emergency vs hypertensive pseudocrisis

Design

Cross-sectional study

Authors

ÂPÂngela Maria Geraldo PierinCFCarime Farah FlóridoJSJuliano dos Santos

Discussion

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Member takes

Overview

Pain may aid ED differentiation of pseudocrisis from emergency; leaves open need for prospective validation.

Study Design

Type

Cross-Sectional (n=508)

Multicenter

No

Structured PICO

What clinical characteristics are associated with hypertensive urgency, emergency, and pseudocrisis in patients presenting to the emergency department?

P
Population
508 adult patients with hypertensive crisis (diastolic blood pressure ≥120 mmHg) evaluated at a public emergency department in Brazil.
O
Outcome
Clinical characteristics and variables associated with hypertensive urgency, emergency, and pseudocrisis.

Main Result

Odds Ratio: 55.58 (95% CI 10.55–292.74)

p-value: p=<0.001

Advanced age and neurological problems are associated with hypertensive emergency, headache with urgency, and pain or emotional problems with pseudocrisis.

Limitations

  • Retrospective data collection from emergency department records
  • Lack of a computerized system leading to manual entry and difficult-to-read records
  • Missing information in records may have led to underestimated prevalences

Cite This Study

Pierin et al. (2019) conducted a cross-sectional in Hypertensive crisis (n=508). Presence of pain (excluding chest pain and headache) vs. Hypertensive emergency was evaluated on Likelihood of hypertensive pseudocrisis compared to hypertensive emergency (OR 55.58, 95% CI 10.55-292.74, p=<0.001). The presence of pain (excluding chest pain and headache) strongly increased the likelihood of hypertensive pseudocrisis compared to hypertensive emergency (OR 55.58).

synapsesocial.com/papers/6aae028cce2016d72f9f7c49https://doi.org/10.31744/einstein_journal/2019ao4685
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Hospital Admissions for Hypertensive Crisis in the Emergency Departments: A Large Multicenter Italian Study2014 · 144 citations
  2. 2Hypertensive crisis2017 · 53 citations
  3. 3Effects of acute blood pressure elevation on biochemical-metabolic parameters in individuals with hypertensive crisis2017 · 12 citations
  4. 4Hypertensive Crisis, Burden, Management, and Outcome at a Tertiary Care Center in Karachi2014 · 31 citations
  5. 5The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure&lt;SUBTITLE&gt;The JNC 7 Report&lt;/SUBTITLE&gt;2003 · 25,569 citations