The aim of this study was to compare cardiovascular (CV) risk factors and comorbidities between hypertensive (HTN) patients admitted for severe HTN urgencies uncontrolled in the emergency department (ED) versus those hypertensives admitted for other criteria.Design and method:
Starting from all hypertensive patients admitted to the Internal Medicine Clinic between December 2012 and December 2015 (5762 pts) we studied those admitted for severe HTN urgencies that did not respond to treatment in the ED and thus necessitated further observation/intervention to obtain blood pressure (BP) control. Patients with HTN emergencies – stroke, acute coronary syndromes (ACS), pulmonary edema, acute renal failure/acutely decompensated chronic renal disease (CRD), were excluded. This population was further evaluated for CV risk factors and comorbidities in comparison to hypertensives admitted for other criteria.Results:
Patients admitted with severe refractory HTN urgencies had a significantly higher CV burden – they were more frequently obese, diabetic, dyslipidemic. These patients had already a more complex CV history including stroke, coronary heart disease (CHD), atrial fibrillation (AF) and peripheral artery disease (PAD). See table.Conclusions:
The results may be explained by the fact that once HTN patients develop either major CV events (stroke/ACS) or established target organ damage, arterial dysfunction makes BP control harder to achieve not only at home but also in the clinical setting over the course of several days.