Association between hypertensive urgencies and subsequent cardiovascular events in patients with hypertension.
OBJECTIVE
To determine whether patients with hypertensive urgency have a higher risk for subsequent cardiovascular events compared with hypertensive patients without this event.


METHODS
Overall, 384 patients with hypertensive urgency and 295 control patients were followed up for at least 2 years. Hypertensive urgency was defined as a systolic blood pressure above 220 mmHg and/or a diastolic blood pressure above 120 mmHg without any evidence of acute end-organ damage. The control group consisted of patients admitted to the emergency department with a systolic blood pressure between 135 to 180 mmHg and a diastolic blood pressure between 85-110 mmHg. The number of cardiovascular events defined as acute coronary syndrome, acute stroke, atrial fibrillation, acute left ventricular failure and aortic aneurysm were consecutively analyzed during follow-up. The median follow-up time was 4.2 years (interquartile range 2.9-5.7 years). Twenty-six patients of the urgency group and 23 patients of the control group were lost for follow-up.


RESULTS
Overall, 117 (17%) patients had nonfatal clinical cardiovascular events and 13 had (2%) fatal cardiovascular events. The frequency of cardiovascular events was significantly higher in patients with hypertensive urgencies (88 vs. 42; P = 0.005). The Cox regression analysis identified age (P < 0.001) and hypertensive urgencies (P = 0.035) as independent predictors for subsequent cardiovascular events.


CONCLUSIONS
Hypertensive urgencies are associated with an increased risk for subsequent cardiovascular events in patients with arterial hypertension.
Vlcek
Marianne
M
Department of Emergency Medicine, General Hospital, University of Vienna.
Bur
Andreas
A
Woisetschläger
Christian
C
Herkner
Harald
H
Laggner
Anton N
AN
Hirschl
Michael M
MM
D054058:Acute Coronary Syndrome / Q000453:epidemiology; D000208:Acute Disease; D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000453:epidemiology; D001281:Atrial Fibrillation / Q000453:epidemiology; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology