An Overview of Hypertensive Crisis Reporting to an Intensive Care Setting

Background: Hypertensive crisis encompasses both hypertensive emergency (HE) and hypertensive urgency (HU). HE occurs when blood pressure (BP) reaches severe levels (>180/120 mmHg) and results in significant organ damage, such as cardiac ischemia, nephropathy, retinopathy, or encephalopathy. On the other hand, HU occurs when BP is severely elevated without organ damage. Given the alarming global and regional statistics, a comprehensive study on hypertensive crises is imperative to develop effective strategies for prevention, early detection, and timely intervention, thus reducing the burden of hypertension-related morbidity and mortality. Methods: The study was designed as a prospective observational study, conducted over a duration of 1.5 years. The researchers employed a consecutive type of non-probability sampling method to select the study sample. A total of 50 patients who met the inclusion criteria were included in the study after obtaining informed consent. The study focused on hypertensive emergencies, excluding cases related to pregnancy and those arising post-operatively. Results: The prevalence of hypertensive crisis in our ICU was observed to be 6.4%. Out of the total 50 cases of hypertensive crisis, 82% were cases with hypertensive emergencies while 18% were cases of hypertensive urgencies. Neurological symptoms were the most commonly reported complaints (54%). Among the 41 cases with hypertensive emergencies, the most common observed target organ damage was in the form of intracerebral hemorrhage (ICH) (n=17), followed by acute left ventricular failure (LVF) (n=9), cerebral infarction (n=5), acute myocardial infarction (AMI) (n=5), unstable angina (n=3), and subarachnoid hemorrhage (SAH) (n=2). Conclusions: The mortality rate among patients with hypertensive crisis is quite high, with one-fourth of the cases failing to survive the condition.