Key result
Comorbidities in ED hypertensive crises linked to ~3.6-fold higher odds of poor outcomes.
Why the study?
Limited evidence exists on the burden, presentation, management, and outcomes of hypertensive crises in Rwandan emergency departments.
Cross-Sectional (n=111)
No
In a Rwandan emergency department, hypertensive crises represented 2.48% of visits and resulted in over half of the patients being admitted, with preexisting comorbidities serving as a strong predictor of admission, referral, or death.
Answers are grounded in this paper and cite their sources.
Comorbidities warrant attention in hypertensive crisis presentations; hypothesis-generating for targeted interventions pending prospective trials.
Background Hypertensive crises at Kibungo Level Two Teaching Hospital. Hypertensive crises are potentially life-threatening conditions defined by systolic blood pressure ≥180 mmHg or diastolic blood pressure ≥120 mmHg. Despite their clinical importance, limited evidence exists on their burden, presentation, management, and outcomes in Rwandan emergency departments. This study assessed the prevalence, clinical characteristics, management, risk factors, and outcomes of hypertensive patients. Methods A retrospective cross-sectional study was conducted among adult ED patients presenting with hypertensive crises between December 2024 and August 2025. Medical records were reviewed for demographic characteristics, clinical presentation, comorbidities, management, and outcomes. Descriptive statistics were used to summarize findings, while logistic regression was performed to identify predictors of poor outcomes, defined as admission, referral, or death. Results Among 4,458 ED visits, 111 patients had hypertensive crises, giving a prevalence of 2.48%. The median age was 68 years, 57.7% were female, and 63.1% had a history of hypertension. Headache (36.0%) and shortness of breath (24.3%) were the most common presenting symptoms. Hypertensive urgency accounted for 73.0% of cases, while 27.0% were hypertensive emergencies. Nifedipine was the most frequently used medication (69.4%), followed by labetalol (20.7%) and furosemide (14.4%). Overall, 51.4% of patients were admitted, 44.1% were discharged, 3.6% were referred, and 0.9% died. Comorbidities were significantly associated with poor outcomes (AOR 3.60; 95% CI: 1.21–10.70; p=0.021). Conclusion Hypertensive crises accounted for 2.48% of ED visits and were associated with substantial hospital admissions. Comorbidities were an important predictor of poor outcomes. Strengthening early risk assessment, evidence-based emergency management, and integrated chronic disease care may improve outcomes.
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Tadesse et al. (2026) conducted a cross-sectional in Hypertensive crisis (n=111). Comorbidities in hypertensive crisis vs. Absence of comorbidities was evaluated on Poor outcomes (composite of hospital admission, referral, or death) (AOR 3.60, 95% CI 1.21-10.70, p=0.021). Comorbidities in ED hypertensive crisis patients were associated with poor outcomes of admission, referral, or death.
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