title: Characteristics, practice patterns, and outcomes in patients with acute hypertension: European registry for Studying the Treatment of Acute hyperTension (Euro-STAT).
abstract: BACKGROUND
  Although effective strategies are available for the management of chronic hypertension, less is known about treating patients with acute, severe elevations in blood pressure. Using data from the European registry for Studying the Treatment of Acute hyperTension (Euro-STAT), we sought to evaluate 'real-life' management practices and outcomes in patients who received intravenous antihypertensive therapy to treat an episode of acute hypertension.
  
  
  METHODS
  Euro-STAT is a European, hospital-based, observational study of consecutive adult patients treated with intravenous antihypertensive therapy while in the emergency department, perioperative unit or ICU. Enrolment took place between 1 July and 15 October 2009 in 11 hospitals in 7 European countries (Austria, Belgium, Germany, Italy, Spain, Sweden and the United Kingdom).
  
  
  RESULTS
  The study population was composed of 791 consecutive patients (median age 69 years, 37% women). Median arterial blood pressure before treatment was 166 mmHg systolic blood pressure (IQR 141 to 190 mmHg) and 80 mmHg diastolic blood pressure (IQR 68 to 95). Nitroglycerine was the most commonly used antihypertensive treatment overall (40% of patients), followed by urapidil (21%), clonidine (16%) and furosemide (8%). Treatment was associated with hypotension in almost 10% of patients. Overall 30-day mortality was 4%, and new or worsening end-organ damage occurred in 19% of patients.
  
  
  CONCLUSIONS
  High blood pressure requiring intravenous therapy is currently managed with a variety of agents in Europe, with those most commonly used being nitroglycerine, urapidil and clonidine. Patients with acute hypertension have substantial concomitant morbidity and mortality, and intravenous antihypertensive treatment is associated with hypotension in almost 10% of cases.
authors.affiliation: Department of Anaesthesia & Intensive Care, Papworth Hospital NHS Foundation Trust, Papworth Everard, Cambridge, CB23 3RE, UK. a.vuylsteke@nhs.net
authors.forename: Alain
authors.initials: A
authors.lastname: Vuylsteke
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
authors.forename: Didier Payen
authors.initials: DP
authors.lastname: de La Garanderie
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Anderson
authors.forename: Leigh
authors.initials: L
authors.lastname: Emery
authors.forename: Allison
authors.initials: A
authors.lastname: Wyman
authors.forename: Sophie
authors.initials: S
authors.lastname: Rushton-Smith
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gore
mesh_terms: D000208:Acute Disease; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003000:Clonidine / Q000008:administration & dosage / Q000627:therapeutic use; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005060:Europe; D005260:Female; D005665:Furosemide / Q000008:administration & dosage / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000401:mortality; D007262:Infusions, Intravenous; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use; D019990:Perioperative Care / Q000706:statistics & numerical data; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
chemical_list: D000959:Antihypertensive Agents; D010879:Piperazines; D005665:Furosemide; C015568:urapidil; D005996:Nitroglycerin; D003000:Clonidine
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